Neuroleptics (Antipsychotics)

Treatment Options - Neuroleptics 

Neuroleptics, also known as antipsychotic medications, are a class of medication used in the treatment of major depressive disorder and other psychiatric disorders, such as schizophrenia and bipolar disorder. 

There are two types of antipsychotic medications:

  • First-generation antipsychotics: In use since the 1950s, these medicines work primarily by altering the signaling of dopamine, a neurotransmitter in your brain. These are also known as typical antipsychotics.
  • Second-generation antipsychotics: In use since the 1990s, with newer versions still being released, these medicines also work by altering dopamine signaling. These are also known as atypical antipsychotics. They also affect the signaling of several other neurotransmitters involved with mood, including serotonin. This may be why atypical antipsychotics have more evidence for improving depression in clinical studies

Major depressive disorder can be difficult to treat to remission, and first-line treatments using antidepressants may not always be effective.

Major depression, therefore, frequently needs alternative treatment approaches. One such approach is modifying the treatment plan to include a second-generation antipsychotic along with antidepressant medication.

The FDA has approved four antipsychotic medications for treatment-resistant depression and major depressive disorders. They are aripiprazole, quetiapine, olanzapine, and brexpiprazole. These are usually given in combination with antidepressant medications.

How do antipsychotic medications work?

Although antipsychotics were originally intended to treat psychosis, some antipsychotic medications may also be used to treat:

  • Severe anxiety 
  • Severe depression
  • Mania
  • Psychotic symptoms of depression

Similar to antidepressants, antipsychotic medications focus on altering brain chemistry. Newer antipsychotic medications treat depression by altering serotonin signaling, the same neurotransmitter impacted by typical antidepressants. 

All antipsychotic medications also alter dopamine signaling in different parts of your brain. Like serotonin, dopamine is another one of the neurotransmitters present in the brain. 

Dopamine carries messages from one part of the brain to another and impacts various activities in your body, including:

  • Movement
  • Memory
  • Pleasurable reward and motivation
  • Behavior and cognition
  • Attention
  • Sleep and arousal
  • Mood
  • Learning
  • Lactation

How long do antipsychotic medications take to work?

Antipsychotic medications usually begin to show improvements in mood for patients within six weeks. However, they can take several months to reach their full effect.

Are antipsychotic medications effective for depression?

Antipsychotic medications have been used in the treatment of depressive disorders for a long time. 

Atypical antipsychotics have the most scientific evidence for the treatment of depression when compared to typical antipsychotics. They are often used in combination with antidepressant medication. This combination can be effective for treatment-resistant depression when antidepressant medications are not enough.

What side effects are most common with antipsychotic medication?

Antipsychotic medication can impact people differently. Each antipsychotic medication has a slightly different set of side effects, so if your Options MD psychiatrist recommends starting an antipsychotic medication, they can help you choose the one that might be best for you. 

Generally, side effects seen with the use of antipsychotic medication may include:

  • Drowsiness
  • Weight gain
  • Increased risk of diabetes 
  • Increased cholesterol (and triglycerides)
  • Constipation
  • Dry mouth
  • Dizziness
  • Blurred vision
  • Uncomfortable restlessness 
  • Uncontrolled movements 
  • Muscle stiffness and spasms

If you experience side effects from antipsychotic medication, please talk to your doctor. It is not safe to stop taking the medication suddenly and without consulting your doctor. It is important to slowly reduce the dosage over a period of time.

Antipsychotic Medication for Depression

Finding the proper treatment when you have treatment-resistant depression can be challenging. Antipsychotic medications can be an effective option for depressive disorders that have not resolved with traditional antidepressants. 

At Options MD, antipsychotics are just one of 200 treatment options that our expert team will consider when putting together a custom plan for your treatment-resistant depression. 

Do you have questions?

Options MD is here to help. Text us to start treatment now. Join our Facebook community to connect with other individuals with treatment-resistant depression.

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