Most common antipsychotic medications by prescriptions dispensed

Antipsychotics are a type of prescription drug that treat the symptom of psychosis.  Psychosis is not a mental illness, but rather a collection of symptoms that affect a person’s ability to tell what is and is not real. These medications are a critical part of treating conditions that involve psychosis. Without treatment, many of these conditions are so severe that patients may require around-the-clock care within a psychiatric hospital.

What are the most common conditions or disorders that are treated with antipsychotics?

Antipsychotic medications treat psychosis-related conditions and their symptoms and are most frequently used by patients with schizophrenia, bipolar disorder, or sudden episodes of mania or depression associated with bipolar disorder.

According to Mayo Clinic:

“Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning and can be disabling. People with schizophrenia require lifelong treatment. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.”

Bipolar disorder was previously known as manic depression. It is a mental illness that causes extreme mood swings with emotional highs (mania or hypomania) and lows (depression). These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.

What causes psychosis?

Certain illnesses can cause psychosis. However, each case of psychosis is different, and the exact cause isn’t always clear. Drug use, lack of sleep, environmental factors, or certain traumatic events can trigger psychosis.

According to the National Institute for Mental Health (NIMH), a person will often show changes in their behavior before psychosis develops. Behavioral warning signs for psychosis include:

• a sudden drop in schoolwork or job performance
• trouble thinking clearly
• difficulty concentrating
• feeling paranoid or suspicious of others
• withdrawing from friends and loved ones
• an influx of strange, new feelings, or no feeling at all
• a disinterest in personal grooming
• difficulty separating reality from non-reality
• trouble communicating

A person experiencing psychosis may often have confusing and disrupted thoughts and/or experience delusions or hallucinations.

What are the different types of antipsychotic medications?

Like other medications used to treat mental health conditions such as depression or anxiety, antipsychotics alter chemicals in the brain and specifically change how the brain uses certain neurotransmitters. Antipsychotics fall into two types of classifications:

• First-generation, or typical antipsychotics, are less commonly used today but were some of the first medications available to treat psychosis. Examples of typical antipsychotic medications include many generics such as chlorpromazine, fluphenazine, and haloperidol.
• Second-generation, or atypical antipsychotics, are the main types of medications to treat psychosis because they have fewer side effects.

What is the difference between first-generation and second-generation antipsychotics?

Both first-generation and second-generation antipsychotic medications block receptors for neurotransmitters such as dopamine and serotonin. Second-generation antipsychotics can also activate other dopamine and serotonin receptors, helping to relieve additional patient symptoms.

Using intelligence from the Definitive Healthcare Atlas Prescription Claims dataset, we’ve ranked the top 10 most prescribed antipsychotics dispensed to U.S. patients between January and September 2023.