Category:Neuroleptics - Revision history

MDElliottMD: Category:Neuroleptics: 'antipsychotics' -> 'neuroleptics' in Notes on scope (house terminology; missed by the #23 follow-up)

2026-05-22T14:59:29Z

Category:Neuroleptics: 'antipsychotics' -> 'neuroleptics' in Notes on scope (house terminology; missed by the #23 follow-up)

← Older revision		Revision as of 14:59, 22 May 2026
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	This category indexes the neuroleptics: the medicines whose defining use is the treatment of psychosis, grouped above by generation. The boundary is that action against psychosis, however the individual medicine achieves it.		This category indexes the neuroleptics: the medicines whose defining use is the treatment of psychosis, grouped above by generation. The boundary is that action against psychosis, however the individual medicine achieves it.

	Several neuroleptics are used well beyond psychosis, and are cross-indexed accordingly. Many of the second- and third-generation agents are central to the treatment of bipolar disorder, in mania and in depression alike; some, quetiapine among them, are used at low doses for sleep or for anxiety; and a few first-generation phenothiazines, prochlorperazine in particular, are used more often as antiemetics than as ~~antipsychotics~~. Following the wiki's multi-membership convention, a medicine is indexed wherever its pharmacology and its uses warrant.		Several neuroleptics are used well beyond psychosis, and are cross-indexed accordingly. Many of the second- and third-generation agents are central to the treatment of bipolar disorder, in mania and in depression alike; some, quetiapine among them, are used at low doses for sleep or for anxiety; and a few first-generation phenothiazines, prochlorperazine in particular, are used more often as antiemetics than as neuroleptics. Following the wiki's multi-membership convention, a medicine is indexed wherever its pharmacology and its uses warrant.

	== About these pages ==		== About these pages ==

MDElliottMD: Category:Neuroleptics: repoint generation links to renamed categories; house terminology (task #23 follow-up)

2026-05-22T14:41:34Z

Category:Neuroleptics: repoint generation links to renamed categories; house terminology (task #23 follow-up)

← Older revision		Revision as of 14:41, 22 May 2026
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	The '''neuroleptics''', more widely known as the antipsychotics, are the medicines used to treat psychosis, the disturbances of thought and perception that mark schizophrenia and the other psychotic illnesses, and used as well in the manic and the depressive phases of bipolar disorder.<ref name="calabrese">Calabrese JR, Keck PE Jr, Macfadden W, et al. A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. ''The American Journal of Psychiatry''. 2005 Jul;162(7):1351–1360. PMID: 15994719.</ref> The class has a definite beginning. Chlorpromazine was synthesized in 1950 by the French company Rhône-Poulenc, the compound RP-4560, out of the phenothiazine family that had already given medicine its antihistamines; the surgeon Henri Laborit, using it to settle patients before operations, saw that it produced a striking calm without heavy sedation and pressed psychiatry to try it. In 1952, at hospitals in Paris, the psychiatrists Jean Delay and Pierre Deniker gave chlorpromazine to psychotic patients and published the first clinical reports of what it could do.<ref name="lopezmunoz">López-Muñoz F, Alamo C, Cuenca E, et al. History of the discovery and clinical introduction of chlorpromazine. ''Annals of Clinical Psychiatry''. 2005 Jul-Sep;17(3):113–135. PMID: 16433053.</ref> Its arrival is generally taken as the start of modern psychopharmacology.<ref name="ban">Ban TA. Fifty years chlorpromazine: a historical perspective. ''Neuropsychiatric Disease and Treatment''. 2007 Aug;3(4):495–500. PMID: 19300578.</ref>		The '''neuroleptics''', more widely known as the "antipsychotics", are the medicines used to treat psychosis, the disturbances of thought and perception that mark schizophrenia and the other psychotic illnesses, and used as well in the manic and the depressive phases of bipolar disorder.<ref name="calabrese">Calabrese JR, Keck PE Jr, Macfadden W, et al. A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. ''The American Journal of Psychiatry''. 2005 Jul;162(7):1351–1360. PMID: 15994719.</ref> The class has a definite beginning. Chlorpromazine was synthesized in 1950 by the French company Rhône-Poulenc, the compound RP-4560, out of the phenothiazine family that had already given medicine its antihistamines; the surgeon Henri Laborit, using it to settle patients before operations, saw that it produced a striking calm without heavy sedation and pressed psychiatry to try it. In 1952, at hospitals in Paris, the psychiatrists Jean Delay and Pierre Deniker gave chlorpromazine to psychotic patients and published the first clinical reports of what it could do.<ref name="lopezmunoz">López-Muñoz F, Alamo C, Cuenca E, et al. History of the discovery and clinical introduction of chlorpromazine. ''Annals of Clinical Psychiatry''. 2005 Jul-Sep;17(3):113–135. PMID: 16433053.</ref> Its arrival is generally taken as the start of modern psychopharmacology.<ref name="ban">Ban TA. Fifty years chlorpromazine: a historical perspective. ''Neuropsychiatric Disease and Treatment''. 2007 Aug;3(4):495–500. PMID: 19300578.</ref>

	Chlorpromazine reached the French market in 1952 as Largactil and the United States in 1954 as Thorazine, and within a few years it had altered psychiatry's institutions as well as its prescriptions: its introduction is widely held to have helped make possible the deinstitutionalization of the following decades, when large numbers of long-stay psychiatric patients were discharged, though historians are clear that social and policy currents drove that shift alongside the medicine.<ref name="lopezmunoz"/> The class has carried several names. The earliest, "major tranquilizer", described the calm; "neuroleptic", from Greek roots meaning roughly to take hold of the nerve, came into use in the 1950s; "antipsychotic" spread in the 1960s. The newest term is the most confident, naming a disease the medicine is supposed to act against, and it sits a little ahead of the science, for the dopamine hypothesis of psychosis on which it rests remains a matter of genuine debate.<ref name="lyman">Lyman M, McCutcheon RA. Antipsychotic drugs at 75: the past, present, and future of psychosis management. ''British Medical Bulletin''. 2025 Sep;156(1):ldaf016. PMID: 41052274.</ref>		Chlorpromazine reached the French market in 1952 as Largactil and the United States in 1954 as Thorazine, and within a few years it had altered psychiatry's institutions as well as its prescriptions: its introduction is widely held to have helped make possible the deinstitutionalization of the following decades, when large numbers of long-stay psychiatric patients were discharged, though historians are clear that social and policy currents drove that shift alongside the medicine.<ref name="lopezmunoz"/> The class has carried several names. The earliest, "major tranquilizer", described the calm; "neuroleptic", from Greek roots meaning roughly to take hold of the nerve, came into use in the 1950s; "antipsychotic" spread in the 1960s. The newest term is the most confident, naming a disease the medicine is supposed to act against, and it sits a little ahead of the science, for the dopamine hypothesis of psychosis on which it rests remains a matter of genuine debate.<ref name="lyman">Lyman M, McCutcheon RA. Antipsychotic drugs at 75: the past, present, and future of psychosis management. ''British Medical Bulletin''. 2025 Sep;156(1):ldaf016. PMID: 41052274.</ref>
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	The neuroleptics are grouped, as psychiatry groups them, into three generations, which mark the order in which they reached use and broadly track their side-effect profiles.		The neuroleptics are grouped, as psychiatry groups them, into three generations, which mark the order in which they reached use and broadly track their side-effect profiles.

	* '''[[:Category:First-~~Generation Antipsychotics (FGAs / Typicals)~~\|First generation (typical)]]''': the medicines of the 1950s onward, dopamine D2 antagonists carrying the greatest burden of movement-related effects. [[chlorpromazine]], [[fluphenazine]], [[perphenazine]], [[trifluoperazine]], [[prochlorperazine]], [[thioridazine]], [[thiothixene]], [[loxapine]], [[molindone]], [[haloperidol]], [[droperidol]], and [[pimozide]].		* '''[[:Category:First-generation neuroleptics\|First generation (typical)]]''': the medicines of the 1950s onward, dopamine D2 antagonists carrying the greatest burden of movement-related effects. [[chlorpromazine]], [[fluphenazine]], [[perphenazine]], [[trifluoperazine]], [[prochlorperazine]], [[thioridazine]], [[thiothixene]], [[loxapine]], [[molindone]], [[haloperidol]], [[droperidol]], and [[pimozide]].
	* '''[[:Category:Second-~~Generation Antipsychotics (SGAs / Atypicals)~~\|Second generation (atypical)]]''': fewer movement effects, more metabolic ones. [[clozapine]], [[risperidone]], [[paliperidone]], [[olanzapine]], [[quetiapine]], [[ziprasidone]], [[asenapine]], [[iloperidone]], [[lurasidone]], and [[lumateperone]].		* '''[[:Category:Second-generation neuroleptics\|Second generation (atypical)]]''': fewer movement effects, more metabolic ones. [[clozapine]], [[risperidone]], [[paliperidone]], [[olanzapine]], [[quetiapine]], [[ziprasidone]], [[asenapine]], [[iloperidone]], [[lurasidone]], and [[lumateperone]].
	* '''[[:Category:Third-~~Generation Antipsychotics~~\|Third generation]]''': the dopamine partial agonists, which modulate dopamine signaling rather than simply blocking it. [[aripiprazole]], [[brexpiprazole]], and [[cariprazine]].		* '''[[:Category:Third-generation neuroleptics\|Third generation]]''': the dopamine partial agonists, which modulate dopamine signaling rather than simply blocking it. [[aripiprazole]], [[brexpiprazole]], and [[cariprazine]].

	== Notes on scope ==		== Notes on scope ==

	This category indexes the neuroleptics: the medicines whose defining use is the treatment of psychosis, grouped above by generation. The boundary is that ~~antipsychotic~~ action, however the individual medicine achieves it.		This category indexes the neuroleptics: the medicines whose defining use is the treatment of psychosis, grouped above by generation. The boundary is that action against psychosis, however the individual medicine achieves it.

	Several neuroleptics are used well beyond psychosis, and are cross-indexed accordingly. Many of the second- and third-generation agents are central to the treatment of bipolar disorder, in mania and in depression alike; some, quetiapine among them, are used at low doses for sleep or for anxiety; and a few first-generation phenothiazines, prochlorperazine in particular, are used more often as antiemetics than as antipsychotics. Following the wiki's multi-membership convention, a medicine is indexed wherever its pharmacology and its uses warrant.		Several neuroleptics are used well beyond psychosis, and are cross-indexed accordingly. Many of the second- and third-generation agents are central to the treatment of bipolar disorder, in mania and in depression alike; some, quetiapine among them, are used at low doses for sleep or for anxiety; and a few first-generation phenothiazines, prochlorperazine in particular, are used more often as antiemetics than as antipsychotics. Following the wiki's multi-membership convention, a medicine is indexed wherever its pharmacology and its uses warrant.

MDElliottMD: Retrofit to canonical category structure: history-first lead (chlorpromazine, Delay and Deniker, the clozapine story), members indexed by generation, Notes on scope and About these pages; added missing Medicines tag; all citations PMID-verified

2026-05-21T07:46:33Z

Retrofit to canonical category structure: history-first lead (chlorpromazine, Delay and Deniker, the clozapine story), members indexed by generation, Notes on scope and About these pages; added missing Medicines tag; all citations PMID-verified

Show changes

MDElliottMD: Phase 2 retag: add Pharmaceutical root parent (taxonomy restructure 2026-05-20)

2026-05-19T19:22:07Z

Phase 2 retag: add Pharmaceutical root parent (taxonomy restructure 2026-05-20)

← Older revision		Revision as of 19:22, 19 May 2026
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	[[Category:MedCategory]]		[[Category:MedCategory]]
	[[Category:MedCategoryFull]]		[[Category:MedCategoryFull]]
			[[Category:Pharmaceutical]]

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:14Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

← Older revision		Revision as of 03:16, 19 May 2026
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	== First- and second-generation neuroleptics ==		== First- and second-generation neuroleptics ==

	The medicines introduced from the 1950s onward — [[chlorpromazine]], [[haloperidol]] and others — are described as '''first-generation''' (or "typical") neuroleptics. They are generally understood to act mainly as antagonists at the dopamine D<sub>2</sub> receptor, and this activity is thought to be related both to their effects and to their characteristic movement-related side effects; the account is a widely used model rather than a complete explanation.<ref name="lyman2025"/>		The medicines introduced from the 1950s onward, [[chlorpromazine]], [[haloperidol]] and others, are described as '''first-generation''' (or "typical") neuroleptics. They are generally understood to act mainly as antagonists at the dopamine D<sub>2</sub> receptor, and this activity is thought to be related both to their effects and to their characteristic movement-related side effects; the account is a widely used model rather than a complete explanation.<ref name="lyman2025"/>

	A '''second-generation''' (or "atypical") group followed, distinguished largely by a reportedly lower tendency to cause movement-related effects. [[Clozapine]], first introduced in Europe in 1971, is generally regarded as the first second-generation neuroleptic.<ref name="crilly2007">Crilly J (2007). The history of clozapine and its emergence in the US market: a review and analysis. ''Hist Psychiatry'' 18(1):39–60. PMID 17580753.</ref> The distinction between the two generations is widely used but has been described as imprecise, since the agents within each group differ considerably from one another.<ref name="lyman2025"/>		A '''second-generation''' (or "atypical") group followed, distinguished largely by a reportedly lower tendency to cause movement-related effects. [[Clozapine]], first introduced in Europe in 1971, is generally regarded as the first second-generation neuroleptic.<ref name="crilly2007">Crilly J (2007). The history of clozapine and its emergence in the US market: a review and analysis. ''Hist Psychiatry'' 18(1):39–60. PMID 17580753.</ref> The distinction between the two generations is widely used but has been described as imprecise, since the agents within each group differ considerably from one another.<ref name="lyman2025"/>
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	== Clozapine and blood monitoring ==		== Clozapine and blood monitoring ==

	[[Clozapine]] was withdrawn from several markets after 1975, when a cluster of cases of [[agranulocytosis]] — a severe loss of white blood cells — in Finland was associated with eight deaths.<ref name="idanpaan1975">Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1975). Clozapine and agranulocytosis. ''Lancet'' 2(7935):611. PMID 51442.</ref> On the basis of trial evidence indicating greater effectiveness in treatment-resistant schizophrenia, it was later reintroduced — approved in the United States in 1989 — under a system of mandatory blood-count monitoring that remains a condition of its use.<ref name="kane1988">Kane J, Honigfeld G, Singer J, Meltzer H (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. ''Arch Gen Psychiatry'' 45(9):789–96. PMID 3046553.</ref>		[[Clozapine]] was withdrawn from several markets after 1975, when a cluster of cases of [[agranulocytosis]], a severe loss of white blood cells, in Finland was associated with eight deaths.<ref name="idanpaan1975">Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1975). Clozapine and agranulocytosis. ''Lancet'' 2(7935):611. PMID 51442.</ref> On the basis of trial evidence indicating greater effectiveness in treatment-resistant schizophrenia, it was later reintroduced, approved in the United States in 1989, under a system of mandatory blood-count monitoring that remains a condition of its use.<ref name="kane1988">Kane J, Honigfeld G, Singer J, Meltzer H (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. ''Arch Gen Psychiatry'' 45(9):789–96. PMID 3046553.</ref>

	== Members ==		== Members ==
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	== Safety ==		== Safety ==

	Reported adverse effects differ between the two generations, and the figures in the literature are population estimates that vary between studies. First-generation neuroleptics have been associated with extrapyramidal effects — including parkinsonism, acute dystonia, akathisia, and the potentially persistent movement disorder tardive dyskinesia.<ref name="lyman2025"/> Second-generation agents have been reported to carry a lower risk of these effects, but have been more commonly associated with metabolic effects, including weight gain, raised blood glucose, and changes in blood lipids. Neuroleptic malignant syndrome is a rare reaction, described in the literature as potentially life-threatening, that has been associated with the class as a whole. Individual response and tolerability are reported to vary considerably between people.		Reported adverse effects differ between the two generations, and the figures in the literature are population estimates that vary between studies. First-generation neuroleptics have been associated with extrapyramidal effects, including parkinsonism, acute dystonia, akathisia, and the potentially persistent movement disorder tardive dyskinesia.<ref name="lyman2025"/> Second-generation agents have been reported to carry a lower risk of these effects, but have been more commonly associated with metabolic effects, including weight gain, raised blood glucose, and changes in blood lipids. Neuroleptic malignant syndrome is a rare reaction, described in the literature as potentially life-threatening, that has been associated with the class as a whole. Individual response and tolerability are reported to vary considerably between people.

	== References ==		== References ==

MDElliottMD: Back-fill wikilinks to Category:Medicines members in running prose

2026-05-17T19:44:46Z

Back-fill wikilinks to Category:Medicines members in running prose

← Older revision		Revision as of 19:44, 17 May 2026
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	== Origins ==		== Origins ==

	Chlorpromazine was synthesized in 1950 by the French pharmaceutical company Rhône-Poulenc as the compound RP-4560, developed from the phenothiazine family that had earlier yielded antihistamines.<ref name="lopezmunoz2005">López-Muñoz F, Alamo C, Cuenca E, et al. (2005). History of the discovery and clinical introduction of chlorpromazine. ''Ann Clin Psychiatry'' 17(3):113–35.</ref> The surgeon Henri Laborit observed that it produced calmness without heavy sedation and suggested a psychiatric use. In 1952 the psychiatrists [[Jean Delay]] and [[Pierre Deniker]], working in Paris, published the first clinical reports of its use in psychotic patients.<ref name="lopezmunoz2005"/> The medicine was marketed in France as Largactil in 1952 and approved in the United States, as Thorazine, in 1954.<ref name="lopezmunoz2005"/>		[[Chlorpromazine]] was synthesized in 1950 by the French pharmaceutical company Rhône-Poulenc as the compound RP-4560, developed from the phenothiazine family that had earlier yielded antihistamines.<ref name="lopezmunoz2005">López-Muñoz F, Alamo C, Cuenca E, et al. (2005). History of the discovery and clinical introduction of chlorpromazine. ''Ann Clin Psychiatry'' 17(3):113–35.</ref> The surgeon Henri Laborit observed that it produced calmness without heavy sedation and suggested a psychiatric use. In 1952 the psychiatrists [[Jean Delay]] and [[Pierre Deniker]], working in Paris, published the first clinical reports of its use in psychotic patients.<ref name="lopezmunoz2005"/> The medicine was marketed in France as Largactil in 1952 and approved in the United States, as Thorazine, in 1954.<ref name="lopezmunoz2005"/>

	Its introduction is widely held to have contributed to the deinstitutionalization movement of the 1950s through the 1970s, during which large numbers of long-term psychiatric inpatients were discharged; historians note that this shift had multiple social and policy causes alongside the arrival of the new medicines.<ref name="lopezmunoz2005"/>		Its introduction is widely held to have contributed to the deinstitutionalization movement of the 1950s through the 1970s, during which large numbers of long-term psychiatric inpatients were discharged; historians note that this shift had multiple social and policy causes alongside the arrival of the new medicines.<ref name="lopezmunoz2005"/>
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	== First- and second-generation neuroleptics ==		== First- and second-generation neuroleptics ==

	The medicines introduced from the 1950s onward — chlorpromazine, [[haloperidol]] and others — are described as '''first-generation''' (or "typical") neuroleptics. They are generally understood to act mainly as antagonists at the dopamine D<sub>2</sub> receptor, and this activity is thought to be related both to their effects and to their characteristic movement-related side effects; the account is a widely used model rather than a complete explanation.<ref name="lyman2025"/>		The medicines introduced from the 1950s onward — [[chlorpromazine]], [[haloperidol]] and others — are described as '''first-generation''' (or "typical") neuroleptics. They are generally understood to act mainly as antagonists at the dopamine D<sub>2</sub> receptor, and this activity is thought to be related both to their effects and to their characteristic movement-related side effects; the account is a widely used model rather than a complete explanation.<ref name="lyman2025"/>

	A '''second-generation''' (or "atypical") group followed, distinguished largely by a reportedly lower tendency to cause movement-related effects. [[Clozapine]], first introduced in Europe in 1971, is generally regarded as the first second-generation neuroleptic.<ref name="crilly2007">Crilly J (2007). The history of clozapine and its emergence in the US market: a review and analysis. ''Hist Psychiatry'' 18(1):39–60. PMID 17580753.</ref> The distinction between the two generations is widely used but has been described as imprecise, since the agents within each group differ considerably from one another.<ref name="lyman2025"/>		A '''second-generation''' (or "atypical") group followed, distinguished largely by a reportedly lower tendency to cause movement-related effects. [[Clozapine]], first introduced in Europe in 1971, is generally regarded as the first second-generation neuroleptic.<ref name="crilly2007">Crilly J (2007). The history of clozapine and its emergence in the US market: a review and analysis. ''Hist Psychiatry'' 18(1):39–60. PMID 17580753.</ref> The distinction between the two generations is widely used but has been described as imprecise, since the agents within each group differ considerably from one another.<ref name="lyman2025"/>
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	== Clozapine and blood monitoring ==		== Clozapine and blood monitoring ==

	Clozapine was withdrawn from several markets after 1975, when a cluster of cases of [[agranulocytosis]] — a severe loss of white blood cells — in Finland was associated with eight deaths.<ref name="idanpaan1975">Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1975). Clozapine and agranulocytosis. ''Lancet'' 2(7935):611. PMID 51442.</ref> On the basis of trial evidence indicating greater effectiveness in treatment-resistant schizophrenia, it was later reintroduced — approved in the United States in 1989 — under a system of mandatory blood-count monitoring that remains a condition of its use.<ref name="kane1988">Kane J, Honigfeld G, Singer J, Meltzer H (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. ''Arch Gen Psychiatry'' 45(9):789–96. PMID 3046553.</ref>		[[Clozapine]] was withdrawn from several markets after 1975, when a cluster of cases of [[agranulocytosis]] — a severe loss of white blood cells — in Finland was associated with eight deaths.<ref name="idanpaan1975">Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1975). Clozapine and agranulocytosis. ''Lancet'' 2(7935):611. PMID 51442.</ref> On the basis of trial evidence indicating greater effectiveness in treatment-resistant schizophrenia, it was later reintroduced — approved in the United States in 1989 — under a system of mandatory blood-count monitoring that remains a condition of its use.<ref name="kane1988">Kane J, Honigfeld G, Singer J, Meltzer H (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. ''Arch Gen Psychiatry'' 45(9):789–96. PMID 3046553.</ref>

	== Members ==		== Members ==

MDElliottMD: Add manual Members section (auto-list hidden on MedCategoryFull pages)

2026-05-17T02:35:43Z

Add manual Members section (auto-list hidden on MedCategoryFull pages)

← Older revision		Revision as of 02:35, 17 May 2026
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	Clozapine was withdrawn from several markets after 1975, when a cluster of cases of [[agranulocytosis]] — a severe loss of white blood cells — in Finland was associated with eight deaths.<ref name="idanpaan1975">Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1975). Clozapine and agranulocytosis. ''Lancet'' 2(7935):611. PMID 51442.</ref> On the basis of trial evidence indicating greater effectiveness in treatment-resistant schizophrenia, it was later reintroduced — approved in the United States in 1989 — under a system of mandatory blood-count monitoring that remains a condition of its use.<ref name="kane1988">Kane J, Honigfeld G, Singer J, Meltzer H (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. ''Arch Gen Psychiatry'' 45(9):789–96. PMID 3046553.</ref>		Clozapine was withdrawn from several markets after 1975, when a cluster of cases of [[agranulocytosis]] — a severe loss of white blood cells — in Finland was associated with eight deaths.<ref name="idanpaan1975">Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1975). Clozapine and agranulocytosis. ''Lancet'' 2(7935):611. PMID 51442.</ref> On the basis of trial evidence indicating greater effectiveness in treatment-resistant schizophrenia, it was later reintroduced — approved in the United States in 1989 — under a system of mandatory blood-count monitoring that remains a condition of its use.<ref name="kane1988">Kane J, Honigfeld G, Singer J, Meltzer H (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. ''Arch Gen Psychiatry'' 45(9):789–96. PMID 3046553.</ref>

			== Members ==
			The first-generation neuroleptics include [[chlorpromazine]], [[fluphenazine]], [[perphenazine]], [[trifluoperazine]], [[thioridazine]], [[thiothixene]], [[loxapine]], the butyrophenone [[droperidol]], and the diphenylbutylpiperidine [[pimozide]]. The second-generation agents include [[clozapine]], [[risperidone]], [[olanzapine]], [[quetiapine]], [[ziprasidone]], [[aripiprazole]], [[paliperidone]], [[asenapine]], [[lurasidone]], [[iloperidone]], [[brexpiprazole]], [[cariprazine]], and [[lumateperone]]. The list is not exhaustive.

	== Safety ==		== Safety ==

MDElliottMD: Add MedCategoryFull marker to enable scoped auto-list hide

2026-05-17T02:09:10Z

Add MedCategoryFull marker to enable scoped auto-list hide

← Older revision		Revision as of 02:09, 17 May 2026
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	[[Category:MedCategory]]		[[Category:MedCategory]]
			[[Category:MedCategoryFull]]

MDElliottMD: Create Category:Neuroleptics with class overview (origins, terminology, first/second-gen, clozapine history, safety; verified citations)

2026-05-16T23:39:53Z

Create Category:Neuroleptics with class overview (origins, terminology, first/second-gen, clozapine history, safety; verified citations)

← Older revision		Revision as of 23:39, 16 May 2026
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	[[~~Haloperidol~~]]		'''Neuroleptics''' (commonly "antipsychotics") are a class of medicines used principally to treat psychosis broadly, as well as chronic psychotic disorders (e.g. [[schizophrenia]]), and bipolar disorder in both manic and depressive phases.<ref name="calabrese2005">Calabrese JR, Keck PE, Macfadden W, et al. (2005). A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. ''Am J Psychiatry'' 162(7):1351–60. PMID 15994719.</ref> The class is generally dated to the introduction of [[chlorpromazine]] into psychiatric practice in 1952, an event widely regarded as the start of the modern era of psychopharmacology.<ref name="ban2007">Ban TA (2007). Fifty years chlorpromazine: a historical perspective. ''Neuropsychiatr Dis Treat'' 3(4):495–500. PMID 19300578.</ref>

			== Origins ==

			Chlorpromazine was synthesized in 1950 by the French pharmaceutical company Rhône-Poulenc as the compound RP-4560, developed from the phenothiazine family that had earlier yielded antihistamines.<ref name="lopezmunoz2005">López-Muñoz F, Alamo C, Cuenca E, et al. (2005). History of the discovery and clinical introduction of chlorpromazine. ''Ann Clin Psychiatry'' 17(3):113–35.</ref> The surgeon Henri Laborit observed that it produced calmness without heavy sedation and suggested a psychiatric use. In 1952 the psychiatrists [[Jean Delay]] and [[Pierre Deniker]], working in Paris, published the first clinical reports of its use in psychotic patients.<ref name="lopezmunoz2005"/> The medicine was marketed in France as Largactil in 1952 and approved in the United States, as Thorazine, in 1954.<ref name="lopezmunoz2005"/>

			Its introduction is widely held to have contributed to the deinstitutionalization movement of the 1950s through the 1970s, during which large numbers of long-term psychiatric inpatients were discharged; historians note that this shift had multiple social and policy causes alongside the arrival of the new medicines.<ref name="lopezmunoz2005"/>

			== Terminology ==

			These medicines have been known by several names. The earliest, "major tranquillizer", described their calming effect; "neuroleptic", from Greek roots meaning roughly "to take hold of the nerve", came into use in the 1950s and refers to their effect on the nervous system. The term "antipsychotic" became common in the 1960s.<ref name="lopezmunoz2005"/> The newer term names a presumed therapeutic target rather than an observed effect; it has been noted that this implies a disease-specific action, while the underlying dopamine hypothesis of psychosis remains a subject of ongoing scientific debate.<ref name="lyman2025">Lyman M, McCutcheon RA (2025). Antipsychotic drugs at 75: the past, present, and future of psychosis management. ''Br Med Bull'' 156(1):ldaf016.</ref> This wiki uses "neuroleptic" as its primary term.

			== First- and second-generation neuroleptics ==

			The medicines introduced from the 1950s onward — chlorpromazine, [[haloperidol]] and others — are described as '''first-generation''' (or "typical") neuroleptics. They are generally understood to act mainly as antagonists at the dopamine D<sub>2</sub> receptor, and this activity is thought to be related both to their effects and to their characteristic movement-related side effects; the account is a widely used model rather than a complete explanation.<ref name="lyman2025"/>

			A '''second-generation''' (or "atypical") group followed, distinguished largely by a reportedly lower tendency to cause movement-related effects. [[Clozapine]], first introduced in Europe in 1971, is generally regarded as the first second-generation neuroleptic.<ref name="crilly2007">Crilly J (2007). The history of clozapine and its emergence in the US market: a review and analysis. ''Hist Psychiatry'' 18(1):39–60. PMID 17580753.</ref> The distinction between the two generations is widely used but has been described as imprecise, since the agents within each group differ considerably from one another.<ref name="lyman2025"/>

			== Clozapine and blood monitoring ==

			Clozapine was withdrawn from several markets after 1975, when a cluster of cases of [[agranulocytosis]] — a severe loss of white blood cells — in Finland was associated with eight deaths.<ref name="idanpaan1975">Idänpään-Heikkilä J, Alhava E, Olkinuora M, Palva I (1975). Clozapine and agranulocytosis. ''Lancet'' 2(7935):611. PMID 51442.</ref> On the basis of trial evidence indicating greater effectiveness in treatment-resistant schizophrenia, it was later reintroduced — approved in the United States in 1989 — under a system of mandatory blood-count monitoring that remains a condition of its use.<ref name="kane1988">Kane J, Honigfeld G, Singer J, Meltzer H (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. ''Arch Gen Psychiatry'' 45(9):789–96. PMID 3046553.</ref>

			== Safety ==

			Reported adverse effects differ between the two generations, and the figures in the literature are population estimates that vary between studies. First-generation neuroleptics have been associated with extrapyramidal effects — including parkinsonism, acute dystonia, akathisia, and the potentially persistent movement disorder tardive dyskinesia.<ref name="lyman2025"/> Second-generation agents have been reported to carry a lower risk of these effects, but have been more commonly associated with metabolic effects, including weight gain, raised blood glucose, and changes in blood lipids. Neuroleptic malignant syndrome is a rare reaction, described in the literature as potentially life-threatening, that has been associated with the class as a whole. Individual response and tolerability are reported to vary considerably between people.

			== References ==

			<references/>

			[[Category:MedCategory]]

MDElliottMD: Created page with "Haloperidol"

2026-05-11T00:24:35Z

Created page with "Haloperidol"

New page

[[Haloperidol]]