Antipsychotics are a type of medication that relieve psychotic symptoms such as delusions, disorganized speech and behavior, and hallucinations. They also reduce the likelihood of relapse and the intensity of symptoms (Lieberman, Stroup & Perkins, 2006).
Although antipsychotics relieve both the positive and negative symptoms of schizophrenia, the former respond to a greater extent than the latter (Lieberman, Stroup & Perkins, 2006).
In the early 1950s, Deniker and Delay observed antipsychotic effects in chlorpromazine, a drug that was introduced in the United States in 1954. This drug was followed by fluphenazine, haloperidol, thioridazine, and perphenazine. All of these drugs had similar effects and were part of what is known as first generation antipsychotics (Lieberman, Stroup & Perkins, 2006).
First-generation antipsychotics act by blocking the brain’s postsynaptic dopamine receptors, and experts believe that it is this blockade in the frontal and limbic cortices that achieves the antipsychotic effect. According to their effect on dopamine receptors and other neurotransmitter systems and their side effects, this group is classified into: high-potency drugs that have a high risk of extramyramidal side effects, a moderate risk of sedation, and a low risk of anticholinergic and antiadrenergic effects; drugs of medium potency with moderate effects; and low potency drugs that have a low risk of extramiramidal side effects, but a high risk of sedation and anticholinergic and antiadrenergic side effects (Lieberman, Stroup & Perkins, 2006).
The second generation antipsychotics They were developed in hopes of reducing side effects and getting better results on the negative symptoms of . The main drugs in this group are clozapine, risperidone, olanzapine, ziprasidone, quetiapine and aripiprazole (Lieberman, Stroup & Perkins, 2006).
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Regarding the comparative effectiveness of both groups of antipsychotics, research has only found modest advantages, in some aspects, of second-generation antipsychotics over first-generation antipsychotics (; ).
Antipsychotic medications can also be injected, a method that would basically offer two advantages: less fluctuation in plasma levels of the drug (which translates into reduced side effects compared to oral administration) and greater adherence to treatment along with control. more effective on the doses applied. The biggest disadvantage is the reluctance of some patients to inject themselves regularly, because it can be painful. Despite the possible advantages of this method, research on the subject continues and has not yet shown clear and significant differences between oral and injectable administration, as can be seen in the following research, , , (Lieberman, Stroup & Perkins, 2006).
Fountain:
Lieberman, J., Stroup, S. & Perkins, D. (2006), Schizophrenia treatise. Lexus editors: Barcelona