Psychosis means losing touch with reality. Hallucinations, delusions, disorganized thinking. Antipsychotic drugs blunt these symptoms by blocking dopamine D2 receptors in the brain, and for many patients they make the difference between hospital and home. They are also used for bipolar mania, severe agitation, and treatment-resistant depression.

The first generation, including haloperidol and chlorpromazine, arrived in the 1950s. They work but often cause movement disorders: stiffness, tremors, and tardive dyskinesia, a potentially permanent condition. Second-generation drugs like risperidone and olanzapine came in the 1990s with fewer movement side effects but a new set of problems, especially weight gain and metabolic changes that raise the risk of diabetes and heart disease. Clozapine, the most effective for treatment-resistant schizophrenia, requires regular blood tests because of a rare but serious risk of low white blood cell count.

What patients and families should know:

• Response varies. Finding the right drug often takes trial and error.
• Side effects are real. Weight, blood sugar, and movement symptoms need monitoring.
• Adherence matters. Stopping abruptly can trigger relapse.
• Long-acting injections. For patients who struggle with daily pills, monthly injections are an option.

Antipsychotics treat symptoms. They do not cure the underlying condition.