Antipsychotics: What They Are, How They Work, and What Alternatives Exist

When someone hears voices, feels paranoid, or loses touch with reality, antipsychotics, a class of psychiatric medications designed to reduce or eliminate symptoms of psychosis. Also known as neuroleptics, they help restore balance in brain chemistry, especially around dopamine. These aren’t party drugs or mood enhancers—they’re serious tools used in hospitals and clinics to help people regain control over their thoughts and behaviors.

Antipsychotics fall into two main groups: first-generation (like haloperidol) and second-generation (like risperidone or olanzapine). The older ones work mainly by blocking dopamine, but they often cause stiff muscles, tremors, or involuntary movements. The newer ones still target dopamine but also affect serotonin, which tends to reduce those movement side effects. Still, they bring their own risks—weight gain, high blood sugar, and tiredness. People on these meds need regular check-ups, not just to see if they’re working, but to catch metabolic changes early.

They’re not just for schizophrenia. Doctors use them for severe bipolar episodes, psychotic depression, and sometimes even severe anxiety or aggression when nothing else works. But they’re not a one-size-fits-all fix. Some people respond to one drug and not another. Others need to try three or four before finding the right fit. And sometimes, combining them with therapy or lifestyle changes makes a bigger difference than the pill alone.

You’ll see posts here comparing antipsychotics to other meds—like how Cymbalta works for depression versus psychosis, or how dexamethasone might be used in acute psychiatric emergencies. There are also guides on what to do when side effects become unbearable, how to safely switch drugs, and what alternatives exist when antipsychotics don’t work or aren’t tolerated. This isn’t a list of miracle cures. It’s a practical collection of real-world advice from people who’ve been there, and doctors who’ve seen what works—and what doesn’t.

Whether you’re someone taking these meds, a caregiver, or just trying to understand why someone you know is on them, the articles below give you the straight facts—no fluff, no hype, just what you need to know to make smarter choices.