Gavazzi, J. D. (2025).
The Tablet, Summer.
This article outlines the history, mechanisms, uses, and evolving developments of antipsychotic drugs, with a focus on their implications for psychologists. It distinguishes between first-generation antipsychotics (FGAs) that primarily block dopamine D2 receptors and second-generation antipsychotics (SGAs) that additionally modulate serotonin receptors, noting their respective strengths and side-effect profiles. Beyond reducing positive symptoms like hallucinations, some antipsychotics can also help with negative symptoms, cognitive deficits, and mood stabilization, though effects are often modest.
The guide covers off-label uses (e.g., depression, OCD, dementia-related agitation) and stresses caution due to variable efficacy and safety risks, especially in older adults. It highlights the importance of individualized treatment, given significant variability in patient response. Emerging options such as lumateperone, xanomeline-trospium, cholinergic modulators, and TAAR1 agonists represent novel approaches with potentially fewer side effects.
Psychologists’ non-prescribing roles include monitoring treatment effects, educating patients and families, delivering psychosocial interventions, and collaborating with prescribers. The overarching message is that optimal care requires a personalized, integrated approach combining pharmacological knowledge with psychosocial strategies.
An Important Takeaway
Even as antipsychotic medications become more sophisticated, there is no “one-size-fits-all” solution—effective treatment comes from balancing science with individualized, compassionate care. Progress in medication is valuable, but it reaches its fullest potential only when paired with human connection, careful monitoring, and collaborative support.
