Antipsychotic medication: what you need to know

Antipsychotic medication treats symptoms like hallucinations, delusions, severe agitation, and mood swings. Doctors most often prescribe them for schizophrenia, bipolar disorder, and sometimes for severe anxiety or behavioral problems. They help many people feel calmer, think clearer, and sleep better.

Types and how they work

There are two main groups: typical (first-generation) and atypical (second-generation) antipsychotics. Typical drugs—older ones like haloperidol—tend to quiet symptoms fast but can cause movement side effects. Atypical drugs—like risperidone, olanzapine, or quetiapine—usually cause fewer movement problems but can affect weight, blood sugar, and cholesterol.

Antipsychotics change how certain brain chemicals work, especially dopamine and sometimes serotonin. That’s how they reduce psychosis and stabilize mood. Different drugs target slightly different pathways, so one med might suit you while another won’t.

What to expect and side effects

Expect a few weeks before full benefits show—some people feel better within days, others need longer. Common short-term side effects include drowsiness, dry mouth, constipation, and blurred vision. Watch for weight gain, diabetes risk, and high cholesterol with some atypical drugs.

Serious but less common effects include tardive dyskinesia (involuntary movements), neuroleptic malignant syndrome (high fever, stiffness), and severe metabolic changes. If you notice uncontrollable movements, very high fever, or sudden mood changes, contact your doctor right away.

Blood tests and weight checks are often part of ongoing care. Your doctor may monitor fasting glucose, lipids, and weight every few months to catch metabolic problems early.

Stopping antipsychotics suddenly can cause withdrawal, rebound psychosis, or return of symptoms. If you want to stop or switch meds, plan a gradual taper with your clinician.

Interactions matter. Some over-the-counter drugs, herbals, and many prescription medicines can change how antipsychotics work. Tell your provider about all meds, supplements, and if you drink alcohol. Certain antipsychotics can make sedation worse with opioids or benzodiazepines.

Pregnancy and breastfeeding need special care. Some antipsychotics are safer than others during pregnancy, but untreated severe mental illness also carries risks. Talk with your psychiatrist and obstetrician before making changes.

Quick checklist for your next visit: what symptom improvements to expect and when, side effects to watch for, needed blood tests, drug interactions, and a clear plan if you miss doses. Ask about lifestyle steps to reduce weight gain—diet advice and exercise plans help a lot.

Antipsychotic medication can be life-changing when used correctly. Keep open communication with your care team, track side effects, and don’t hesitate to ask questions. If something feels wrong, report it—small changes now can prevent big problems later.