Robinson, K. M. (2024, June 18). First- and Second-Generation Antipsychotics for Schizophrenia. WebMD. https://www.webmd.com/schizophrenia/first-second-generation-antipsychotics

Treatment of Schizophrenia using 1st-Generation and 2nd-generation Antipsychotics

First-generation, or conventional, antipsychotics are dopamine-antagonist medications used to treat schizophrenia. By blocking dopamine's effects, they can reduce positive symptoms such as hallucinations and delusions. Chlorpromazine is an example of this class.

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Earlier, there were no treatments to help people who are suffering from schizophrenia. Add to this the neglected institutions where patients were not cared for, people were desperate for treatment and they resorted to a procedure called lobotomy.
Other treatments are: 
- Psychosurgery 
- Drug called Chlorpromazine

Currently, there are additional therapies used for treatment of schizophrenia.

In 2020, The American Psychiatric Association released a clinical practice guideline with pharmacotherapy and psychosocial intervention recommendations.

Pharmacotherapy recommendations:
- Antipsychotic medication (2nd generation agents)
- Clozapine for treatment-resistant patients OR patients with persistent suicidal thoughts/attempts OR consistent hostility and aggressive tendencies)

Psychosocial Intervention recommendations
- A specially coordinated care program created for patients who undergo their first episode of psychosis
- Cognitive-behavioral therapy

Treatment of Schizophrenia 

Certain symptoms of schizophrenia are linked to excessive dopamine activity. To treat these symptoms, antipsychotic medications function as dopamine antagonists. They bind to dopamine receptors without activating them, which blocks naturally occurring dopamine from attaching and prevents it from transmitting information to adjacent neurons.

Schizophrenia Treatment with Dopamine Antagonists

It is the surgical separation of the parts of the frontal lobes from the rest of the brain. Even though there was no scientific evidence behind this treatment, few recoveries made it seem like this was helping patients with schizophrenia. 
An image of the same is attached below: 

Lobotomy: Earliest Treatment of Schizophrenia 

Also known as the neurosurgery for mental disorders, psychosurgery is the surgical modification of the brain to treat psychiatric disorder. It involves much smaller lesions and is rarely performed (last resort). It can be used for many other disorders also such as severe epilepsy. 

Treatment of Schizophrenia : Psychosurgery 

 An antipsychotic drug, one of the class of phenothiazines, this drug proved to be a actual treatment of schizophrenia as it was found that chlorpromazine reduces the positive symptoms of schizophrenia such as the hallucinations, delusions and disordered thinking. Also known as Thorazine, it revolutionized psychiatry and helped many patients. 

Treatment of Schizophrenia: Chlorpromazine

2nd-generation antipsychotics, also known as atypical antipsychotics, are different from 1st-generation in that they are not primarily dopamine antagonists and they dont just reduce positive symptoms, but also negative symptoms like apathy and alogia. They are not found to be more effective or be better tolerated than 1st generation in treatment as it depends on the patient and what works for them.

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