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Anti-Psychotic Medication: Treatment for Bipolar Disorder

Along with anticonvulsants, doctors may prescribe their bipolar patients anti-psychotics, medication that treats a patient's disconnect from reality (known medically as psychosis). Typically, doctors recommend anti-psychotic medication to their patients who suffer from hallucinations and delusions, such as schizophrenics. However, like anticonvulsants, anti-psychotic medication has proven to be an effective mood stabilizer. As a result, doctors prescribe it to their bipolar patients, whether or not these patients suffer from psychosis.

Early forms of anti-psychotic medication had side effects that seriously hampered a person's motor skills, causing tremors characteristic of Parkinson's disease. This side effect led some to refer to anti-psychotics as neuroleptics, a term that literally translates from Greek to mean "to take hold of one's nerves." While newer forms of anti-psychotics have far fewer side effects on the motor skills, this class of drugs may still be referred to by some as neuroleptics.

Types of Antipsychotic Medication

Currently, the three types of antipsychotic medication in order of their development are:

first-generation (typical)
second-generation (atypical)
dopamine partial agonists.

Typical Anti-Psychotics: First-Generation Medication

First developed during the 1950s as a schizophrenia treatment, typical anti-psychotics are still used today to treat a variety of conditions, including the mania associated with bipolar disorder. Because early forms of typical anti-psychotics had extreme sedative properties, this class of drugs was also known as "major tranquilizers."

However, because newer medications have limited this sedative property, few, if any, medical professionals still use the term major tranquilizer when referring to typical anti-psychotic medication.

This first-generation medication comes in two forms. Each has its own unique risks and benefits:

High Potency: While high-potency first-generation anti-psychotics are effective without causing sedation, dry mouth or dizziness, side effects include impaired motor skills (i.e., either the inability to move or the inability to stop tremors). Common high-potency typical anti-psychotic medications include Fluphenazine and haloperidol.
Low Potency: In contrast to the high-potency form, low-potency typical anti-psychotic medication has far less effect of the motor skills (i.e., less extrapyramidal side effects). However, side effects include poor concentration and occasional memory loss. Examples of low potency medication include Chlorpromazine and Thiothixene.

Serious, but rare, side effects associated with the use of any typical antipsychotic include:

Neuroleptic Malignant Syndrome (NMS): a potentially fatal condition accompanied by fever, altered mental states and muscle stiffness.
Tardive Dyskinesia: a disorder marked by involuntary, needless movement (i.e., blinking, tongue protrusion, etc.).

While the elderly are more likely to suffer from serious side effects of typical antipsychotic medication, anyone experiencing symptoms should see his doctor and discontinue use.

Atypical, Second-Generation Anti-Psychotics

While this class of antipsychotic medication is a heterogeneous group that includes a variety of different medication, drugs in this category tend to affect hormone receptors, both serotonin and dopamine, in the brain. Although some doctors consider atypical antipsychotic medications to be more effective than the first-generation medication, research has yet to bolster this conclusion.

Because atypical anti-psychotics are newer, doctors are still unsure of exactly how they work to stabilize the mood. As a result, doctors generally rely on first-generation medications.

Common atypical anti-psychotics include:

Amisulpride
Aripiprazole
Bifeprunox
Clozapine
Melperone
Sertindole
Olanzaine.

Potential side effects include developing:

diabetes
hypoglycemia
tardive dyskinesia.

Dopamine Partial Antagonist

As one of the newest forms of anti-psychotic medication, dopamine partial antagonists are drugs that only partly block the dopamine receptors in the brain. Because this type of anti-psychotic medication deals with the dopamine receptor, it is often categorized as an atypical anti-psychotic. However, researchers still have much to discover about dopamine partial antagonists.

Although this medication is an effective mood stabilizer, side effects include:

depression, general discontent
poor concentration
restlessness, general agitation
tardive dyskinesia.

Currently, the only FDA-approved dopamine partial antagonists is Aripipazole.

Resources

Answers.com (2007). Typical Antipsychotic. Retrieved July 19, 2007 from the Answers.como Web site: http://www.answers.com/topic/typical-antipsychotic.

Free Patents Online (2007). Use of Dopamine Receptor Antagonsits. Retrieved July 19, 2007 from the Free Patents Online Web site: http://www.freepatentsonline.com/20010056101.html.

Healthy Place (2007). Recent Developments in Atypical Antipsychotic Medications. Retrieved July 19, 2007 from the Healthy Place Web site: http://www.healthyplace.com/communities/
Thought_Disorders/schizo/medications/index.asp.

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