Drug Therapy for Schizophrenia

Drug therapy (pharmacotherapy) is the most common treatment for schizophrenia and typically forms the first line of intervention. There are two main classes of antipsychotic medication: typical (first-generation) antipsychotics and atypical (second-generation) antipsychotics. This lesson examines their mechanisms, effectiveness, and the ethical and practical issues surrounding their use.

Key Definition: Antipsychotic drugs are medications used to manage psychotic symptoms such as hallucinations and delusions. They work primarily by altering neurotransmitter activity in the brain, particularly dopamine.

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Typical Antipsychotics

Typical antipsychotics were the first class of antipsychotic drugs developed and have been in use since the 1950s. The most well-known is chlorpromazine (brand name: Largactil/Thorazine).

Mechanism of Action

Typical antipsychotics are dopamine D2 receptor antagonists — they bind to D2 receptors in the brain and block them, preventing dopamine from exerting its effects. By reducing dopamine activity in the mesolimbic pathway, they alleviate positive symptoms such as hallucinations and delusions.

The process can be summarised as follows: