Top 7 Antipsychotics
Schizophrenia, bipolar affective disorder, acute and chronic psychosis are diseases and conditions for which neuroleptics are used. We found out which antipsychotics are considered effective, how they work, and why they should not be taken without a doctor’s prescription

Antipsychotics or antipsychotics are used to correct and treat mental disorders that are accompanied by delusions, hallucinations, obsessive fears, anxiety, and manic states.1. Medicines from this group are widely used in psychiatry and narcology.

What are antipsychotics in simple words

Antipsychotics affect different structures of the brain and have a versatile effect: they reduce psychomotor agitation, help reduce anxiety and aggression, get rid of phobias and hallucinations1.

There are two groups of antipsychotics – typical and atypical.1. Typical include Haloperidol, Chlorprothixene and other drugs that block predominantly dopamine receptors in the brain2. Along with efficiency, they have a serious drawback – a large number of side effects. This is, first of all, tremor, muscle tone disorders, “minching gait”, restlessness and convulsions.2,3.

Atypical antipsychotics are new generation drugs. They act more selectively on dopamine receptors, so they are much less likely to cause movement disorders and are generally better tolerated than typical antipsychotics.3. This group includes Olanzapine, Seroquel, Risperidone3.

List of top 7 inexpensive and effective antipsychotics according to KP

With expert, psychotherapist Yulia Zyuganova we have selected 7 best antipsychotics of domestic and foreign manufacturers. It’s worth clarifying right away that the concept of “the best antipsychotics” is conditional. There are no drugs that help all patients and do not have side effects. Each neuroleptic has its pros and cons. Therefore, our rating is compiled for informational purposes only and includes drugs that are most often used in clinical practice.

All neuroleptics are strong prescription drugs that must be prescribed by a doctor. With uncontrolled use, the most effective neuroleptic can be useless and often very dangerous.

1. Seroquel

It is an atypical antipsychotic that is used in the treatment of schizophrenia and bipolar affective disorder. The drug helps to cope with the manifestations of acute and chronic psychoses, depressive and manic states. Seroquel is intended for adults, the standard regimen is 1 tablet twice a day4.

Contraindications: age up to 18 years, lactation period, hypersensitivity to components, simultaneous use of erythromycin, clarithromycin and nefazodone. Reception during pregnancy is possible only under the supervision of a doctor4.

The price of the drug depends on the dosage. On average, a package of 60 tablets will cost from 1000 to 2200 rubles.

according to many doctors – an effective antipsychotic with a mild effect.
causes dependence syndrome and weight gain in some patients.

2. Olanzapine

Olanzapine is an atypical antipsychotic and is indicated for the prevention of relapse in patients with bipolar affective disorder, as well as for the treatment of schizophrenia, manic episodes, and depression that has not been managed with two or more antidepressants.5. The recommended starting dose is 5 to 20 mg per day. Available in tablets with a dosage of 5 and 10 mg.

Olanzapine is contraindicated in individual intolerance, children and adolescents under 18 years of age, lactating women, people with lactase deficiency and lactose intolerance. Use during pregnancy is possible if the expected benefit to the mother is higher than the potential risk to the fetus5.

The price of a package of 28 tablets with a dosage of 10 mg in the pharmacy chain is from 600 to 800 rubles.

helps to cope with anxiety and aggression, normalizes sleep.
can provoke a large weight gain and a feeling of lethargy in the first weeks of use, sometimes exacerbates depression, therefore it is prescribed with great care.

3. Risperidone

Another atypical neuroleptic of the new generation, which is actively used for the treatment of bipolar affective disorder6. The drug is taken 1 or 2 times a day. Available in tablets that contain 2 or 4 mg of active ingredient.

Risperidone is contraindicated under the age of 18 years, with intolerance to the components, lactase deficiency, lactose intolerance. Pregnant women can only take the drug with the permission of a doctor.6.

The average price for a package of 20 tablets with a dosage of 4 mg is from 400 to 500 rubles.

eliminates anxiety, stabilizes mood and improves sleep.
Patients often complain of side effects such as weight gain, constipation and visual disturbances.

4. Ariprizole

The drug from the group of atypical antipsychotics contains the active ingredient aripiprazole and is used to treat schizophrenia, bipolar affective disorder, neurotic and depressive disorders7. Studies by psychotherapists from the United States have shown that aripiprazole also has a beneficial effect on patients with borderline personality disorder. The drug is available in tablets with a dosage of 10, 15 and 30 mg.

Contraindications to the use of Aripizol: age up to 18 years, senile dementia, individual hypersensitivity to the components, lactation7.

Ariprazol does not apply to budget drugs: for a package of 30 tablets, you need to pay from 4000 to 7000 rubles.

helps to normalize mood and sleep, improves memory, relieves depression, increases activity and stabilizes the patient’s social life.
high price in the segment, not always on sale, can cause nausea, arrhythmia and insomnia.

5. Haloperidol

One of the “oldest” and most famous typical antipsychotics. Currently, it is not used very often due to the large number of side effects. However, in some cases it is indispensable, for example, with delusional disorders, alcoholic psychoses and other disorders with psychomotor agitation.8. In these cases, Haloperidol serves as a means of “ambulance”.

The drug is available as an injection solution and in tablets that contain 1,5 and 5 mg of the active substance. Tablets with a dosage of 1,5 can be used to treat children older than 3 years.

Contraindications for use: pregnancy, lactation, severe disorders of the central nervous system, Parkinson’s disease8.

Haloperidol is inexpensive – a pack of 50 tablets will cost only 70-100 rubles.

high efficiency in the relief of acute symptoms, affordable price.
very often causes restlessness, trembling of the limbs, uncontrolled body movements, as well as urinary retention, visual disturbances and tachycardia.

6. Chlorprothixene

Like Haloperidol, it is a long and well-studied drug from the group of typical antipsychotics. Today, it is prescribed with caution due to the high likelihood of side effects. Nevertheless, Chlorprothixene remains an effective remedy for combating anxiety and psychomotor agitation in schizophrenia, epilepsy, oligophrenia, and withdrawal symptoms.9. Release form – tablets with a dosage of 15 and 50 mg.

Contraindications: pregnancy, lactation, severe CNS depression, hypersensitivity to cloprothixene, myelodepression, age over 65 years, severe liver and kidney dysfunction9.

The average price for a pack of 30 tablets depends on the dosage and ranges from 250 to 600 rubles.

copes well with anxiety, insomnia, hallucinations, obsessive-compulsive disorders.
there are many side effects, the most common are increased anxiety, a feeling of “unreality” of what is happening, sweating, constipation, dry mouth.

7. Clopixol

Klopiksol belongs to typical antipsychotics and is effective in acute psychomotor agitation, manic states and psychoses.10. Doctors consider it a “workhorse” for acute conditions and are usually prescribed in a hospital setting.

The drug is potent – after intramuscular injection of one ampoule, the patient can fall asleep for 2-3 days. In addition to the injection solution, Clopixol tablets are produced.

The drug is contraindicated in acute poisoning with alcohol, opiates and barbiturates. The injection solution should not be used during pregnancy and lactation.10.

A pack of 50 tablets with a dosage of 2 mg, on average, costs 60 rubles.

quickly and effectively copes with psychomotor agitation, affordable price in the segment.
poorly suited for “home” use, severe tolerance, frequent side effects – fainting, confusion.

How to choose a neuroleptic

Choosing an antipsychotic is a very individual process. The doctor must take into account literally everything: the symptoms, the age of the patient, the level of intelligence, emotional characteristics, the severity of the condition, the duration of the disease. In some cases, suicidal risk (a person’s propensity to commit suicide) is assessed.

Reviews of doctors about antipsychotics

 – My opinion about these drugs is ambiguous. I have a positive attitude towards situations where antipsychotics are prescribed as needed: for schizophrenia, delusional states and psychoses. But when I see that colleagues prescribe antipsychotics even for mild anxiety disorders, it surprises and alarms me. Antipsychotics should be used for severe conditions, but not for mild disorders.

Recently, I have also observed a tendency for the growth of neuroleptic drug addicts among young people. Young people acquire the drug and deliberately take it in large dosages to achieve an “effect”. I consider it right to tighten control over the prescription of drugs in this group, – says psychotherapist Yulia Zyuganova.

Popular questions and answers

The most popular questions regarding the appointment of neuroleptics are answered by a psychotherapist, psychologist Yulia Zyuganova.

How do neuroleptics affect the brain?

– The effect of neuroleptics on the brain with prolonged use is deplorable. First, almost all antipsychotics cause dependence syndrome. At some point, the patient simply will not be able to do without them. Secondly, antipsychotic drugs block the action of certain impulses of the central nervous system. What does it mean? From the positive – aggressiveness and an excited state disappear. From the negative – a person experiences indifference to the environment, may lose the instinct of self-preservation, acquires emotional dullness, roughly speaking, falls into a “vegetable” state. Thirdly, with prolonged use of the drug in high doses, some patients also experienced a decrease in brain volume.

What happens if you suddenly stop taking antipsychotics?

– With the abrupt cancellation of antipsychotics, there is a risk of the symptoms returning in even greater intensity and strength, as well as the formation of an abstinence syndrome. This is a withdrawal syndrome in which the patient experiences all the torment of a real drug withdrawal: the patient becomes aggressive, uncontrollable, sleep is lost, severe headaches, nausea, dizziness and many more disorders of the central nervous system occur.

How do tranquilizers differ from antipsychotics?

Tranquilizers are anti-anxiety, sedative drugs. The main distinguishing feature is that tranquilizers do not have an antipsychotic effect, that is, they will not help with delusional states, hallucinations. Roughly speaking, tranquilizers cause calmness, and antipsychotics indifference.

Unlike neuroleptics, tranquilizers do not affect autonomic functions in any way and do not cause such disorders as involuntary muscle contraction, impaired coordination, and trembling of the limbs. However, psychological and physical dependence quickly develops to tranquilizers – this is their main disadvantage.

Sources of:

  1. Register of medicines of Russia. neuroleptics. https://www.rmj.ru/articles/psikhiatriya/Sovremennaya_antipsihoticheskaya_farmakoterapiya_shizofrenii/
  2. Lectures for doctors. A. T. Davydov, E. M. Krupitsky, M. L. Remizov, I. A. Zagrebelny, T. L. Kotelnikova, P. D. Shabanov. “Peculiarities of the clinical use of typical antipsychotic drugs in psychiatric and narcological practice”. https://cyberleninka.ru/article/n/osobennosti-klinicheskogo-ispolzovaniya-tipichnyh-antipsihoticheskih-preparatov-v-psihiatricheskoy-i-narkologicheskoy-praktike/viewer
  3. Русский медицинский журнал №10 от 29.05. 2004. Мосолов С. Н. «Современная антипсихотическая терапия шизофрении». https://www.rmj.ru/articles/psikhiatriya/Sovremennaya_antipsihoticheskaya_farmakoterapiya_shizofrenii/
  4. Vidal. Reference book of medicines. Seroquel. https://www.vidal.ru/drugs/seroquel__39510
  5. Vidal. Reference book of medicines. Olanzapine. https://www.vidal.ru/drugs/olanzapine__43301
  6. Vidal. Reference book of medicines. Risperidone. https://www.vidal.ru/drugs/risperidone__23278
  7. Vidal. Reference book of medicines. Ariprisol. https://www.vidal.ru/drugs/ariprisol__45152
  8. Vidal. Reference book of medicines. Haloperidol. https://www.vidal.ru/drugs/haloperidol__4318
  9. Vidal. Reference book of medicines. Chlorprothixene. https://www.vidal.ru/drugs/chlorprothixen
  10. Register of medicines of Russia. Clopixol. https://www.rlsnet.ru/drugs/klopiksol-7389

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