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Antipsychotics – a horrible replacement for even worse alternatives

    A supposed relief from barbaric treatments

    Before 1952 and the introduction of the first antipsychotic drug, chlorpromazine, psychiatry was relying on ‘treatments’ for psychosis or schizophrenia such as lobotomy, electroshock and chemical shock using insulin or drugs like cardiazol. 1

    These ‘therapies’ came with severe side effects which were often despised by the public and even some psychiatrists were repulsed by what they were doing. Antipsychotic drugs then were seen much as a ‘relief’ as an advancement. At least psychiatrists weren’t tearing through brain tissues as in lobotomy.

    Antipsychotic drugs

    No cause or cure – the ‘chemical straightjacket’

    Having failed in any attempt to cure what they called schizophrenia, psychiatrists are glad just to have something that makes their patients quiet, tractable and easily managed, despite any side effects.

    Psychiatry has no idea of the actual cause of the various things they label as psychosis or schizophrenia.

    Unlike the fraud of the ‘chemical imbalance’ in depression, there isn’t even an attempt to pass off antipsychotics as a cure for anything. They merely suppress symptoms and indeed some of the uses these drugs are put to can only be described as keeping people tractable.

    These drugs have long been known as the ‘chemical straightjacket’. 2 3

    Indeed, when the first antipsychotic, chlorpromazine [marketed as Largactil and Thorazine] emerged in the 1950s it was gleefully described by psychiatrists as a ‘chemical lobotomy’ – as though this was something to aim for. 4

    A most appalling example of the drugs being used to merely keep people tractable is in their use in the often understaffed and poor conditions of nursing homes. In 2021 a New York Times investigation found that 21% of nursing home occupants were on antipsychotics and persons were ‘diagnosed’ with schizophrenia on arrival to justify it. 5 A paper in 2018 found rates of antipsychotic use in Australian nursing homes varied from 13% to a shocking 45%. 6

    Having failed in any attempt to cure what they called schizophrenia, psychiatrists are glad just to have something that makes their patients quiet, tractable and easily managed, despite any side effects. 7

    Typical and atypical antipsychotics

    All of them, simply, shut down functions of the brain and so the ‘chemical straightjacket’ label.

    These two terms loosely describe first-generation antipsychotics: typical and second-generation antipsychotics: atypical.

    Both generations of antipsychotics are based on limiting dopamine effectiveness in the brain. Dopamine is a chemical produced by the brain that assists in the communication between neurons. The difference is that second-generation antipsychotics also limit serotonin effectiveness – also a communication assistant, but affecting different bodily functions and responses than dopamine. 8

    All of them, simply, shut down functions of the brain and so the ‘chemical straightjacket’ label.

    The first-generation antipsychotics or ‘typical’ were developed from the 1950s forward with the second-generation antipsychotics or ‘atypical’ introduced in the 1990s. Despite claims that ‘typical’ antipsychotics have far more severe side effects than ‘atypical’, they remain in use.

    Antipsychotic side effects

    “The use of antipsychotic medications entails a difficult trade-off between the benefit of alleviating psychotic symptoms and the risk of troubling, sometimes life-shortening adverse effects.” Adverse Effects of Antipsychotic Medications. American Family Physician. 2010. 9

    Just to be clear, a lack or excess of dopamine or serotonin is NOT the cause of psychosis or schizophrenia. The use of antipsychotics is an artificial intervention in the natural chemistry of the body affecting not only symptoms of psychosis or schizophrenia, but other brain and body functions as well and obviously will result in side effects. Side effects can vary depending on the drug taken and doses.

    Involuntary Body Movement


    “Subjectively, akathisia may present with an inner restlessness that involves mainly the legs but can also involve the arms or trunk, a compulsion to move, dysphoria [feeling of discomfort or distress], anxiety, inner tension, and other less common symptoms such as rage, fear, nausea, or worsening of psychotic symptoms. Objectively, akathisia may present with fidgetiness of the hands, arms, and limbs, complex repetitive movements, persistent swinging and crossing and uncrossing of the legs, moving from foot to foot, walking, and pacing.” 10

     A 2017 study found estimates for chronic akathisia and “pseudoakathisia” [objective symptoms only] prevalence at 24% and 18%, respectively in patients with schizophrenia. 11

    Psychiatry states there are two types of akathisia: a) medication-induced akathisia which results from starting or raising a medication dose or reducing other medication taken to handle involuntary movement symptoms, and b) ‘tardive akathisia’ which can occur late in the course of treatment, usually three months after medicine or dose change, and which can go on for months or years even when no longer on medications or dosage reduction.

    Tardive dyskinesia

    “Tardive dyskinesia, a condition that causes involuntary movements, such as frowning, tongue movements, and lip-puckering, can be a side effect of long-term use of certain antipsychotic drugs…”

    This condition is evident in 25% of persons who have taken antipsychotics in the long term and can take years to remedy and in some cases will be permanent. 12 13


    Drug-induced Parkinsonism has almost identical symptoms to Parkinson’s disease and patients can often be misdiagnosed as having the disease itself.

    It is the most common movement type side effect of antipsychotics. The frequency of the condition among patients varies greatly depending on the drug taken but can range from 2.4% to 29%. In a population of long-stay persons in mental health facilities receiving antipsychotic treatment, Parkinsonism reached 20.8%. 14 15

    The symptoms include; tremors including resting tremors, muscle stiffness, slow gait and movements, problems with posture and balance and impaired speech.

    Both typical and atypical antipsychotics can bring about drug-induced Parkinsonism. 16 17


    “Dystonias are involuntary contractions of antagonistic muscle groups [one relaxes, the other contracts], leading to twisting, sustained and repetitive motions or abnormal postures, most commonly in the head, face and neck. These can be painful and highly distressing…. Dystonias typically occur within hours to days of antipsychotic administration or dose increase, almost always within the first five days.” 18

    A 2020 study found 6.8% of a group of adults and children treated with antipsychotics developed dystonias. 19

    Sudden cardiac death

    Large studies of antipsychotic users have found a small risk of sudden cardiac death. There was no significant difference between typical or atypical antipsychotics and the risk was highest when persons were actually receiving the drugs, not after. A 2001 study of 481, 744 persons on antipsychotics found 1,487 confirmed resultant deaths. 20 21

    Neuroleptic malignant syndrome

    This syndrome is rare but potentially life-threatening. It can occur when you take antipsychotics or months after. Symptoms are: High fever (102 to 104 F), muscle stiffness, sweating a lot, anxiety or other changes in mental state, fast or abnormal heartbeat, quick breathing and more saliva than usual. Among other things, it can cause heart, lung and kidney failure and pneumonia. 22


    Antipsychotic drugs can often result in constipation, which if not treated can bring about further complications and even death. Persons on antipsychotics have been found to downplay this side effect and yet should be medically monitored to ensure complications do not occur. 23

    Weight Gain – Diabetes

    Most antipsychotics produce weight gain which can result in factors that will produce Metabolic syndrome. This syndrome directly affects conditions in the body that result in diabetes and heart disease. This weight gain can increase the risk of diabetes by 5X and heart disease by 2x over a period of 5 years. A study of persons with schizophrenia found Metabolic syndrome present in 35%. 24

    Sexual dysfunction

    This is a common side effect of antipsychotics and is reported as occurring in 45 to 80% of males and 30 to 80% of females. A 2012 study of women on antipsychotics found that 44% had experienced menstrual irregularities from irregular flows to none. 25 26

    Sedation and sleep

    Depending on the drug used and doses, sedation can be a significant side effect resulting in lessened social activity and even inability to function at work. It has also been noted as a factor in blood clots in the veins found in persons on antipsychotics. Lessened sleep is also a known factor as a result of these drugs.27

    Orthostatic hypotension

    This simply means a low blood pressure effect found when you stand up from sitting or laying down. Antipsychotics commonly produce this side effect. When severe it can produce heart attack or stroke. 28

    Behavioral addictions/impulse control disorders

    Some antipsychotics can result in side effects of compulsive behaviours including hypersexuality, gambling, shopping, and eating all taken to potential damaging extremes. These are said to cease when the particular drug is no longer used.  29

    Brain shrinkage and damage

    Studies have confirmed that antipsychotics cause brain shrinkage and alterations to brain structure. Resultant changes in cognitive functioning and body motor controls observed in patients suggest that other adverse changes are produced in the brain through the use of these drugs. The long-term effects of these changes and the extent of brain damage have yet to be fully researched. 30 31

    Risk of death for the elderly

    In 2005 the US Food and Drug Administration issued a Public Health Advisory that atypical antipsychotics poised a health risk to the elderly. Even more poignant considering the misuse of antipsychotics in retirement homes.

    “The Food and Drug Administration has determined that the treatment of behavioral disorders in elderly patients with dementia with atypical (second generation) antipsychotic medications is associated with increased mortality. Of a total of seventeen placebo-controlled trials performed with olanzapine (Zyprexa), aripiprazole (Abilify), risperidone (Risperdal), or quetiapine (Seroquel) in elderly demented patients with behavioral disorders, fifteen showed numerical increases in mortality in the drug-treated group compared to the placebo-treated patients. These studies enrolled a total of 5106 patients, and several analyses have demonstrated an approximately 1.6-1.7 fold increase in mortality in these studies. Examination of the specific causes of these deaths revealed that most were either due to heart related events (e.g., heart failure, sudden death) or infections (mostly pneumonia).” 32

    Clozapine specific

    In addition to the more general side effects, clozapine has some that are specific to it. These can include neutropenia ( low levels of certain white blood cells), agranulocytosis (severely low levels of white blood cells) and myocarditis (inflammation of the heart). 33

    Other side effects

    There are other side effects that, by comparison, are relatively minor such as dry mouth, fast heart rate, blurry vision and increased breast milk.

    Forever antipsychotics

    Despite statements of the dangers of the drugs, psychiatry simply has no technology to replace them that would actually cure what they call psychosis or schizophrenia.

    Statements regarding relapse rates for antipsychotics are meaningless as these drugs do not even attempt a cure. They have no lasting effect except for dangerous side effects.

    Despite statements of the dangers of the drugs, psychiatry simply has no technology to replace them that would actually cure what they call psychosis or schizophrenia.

    “While the option of successfully discontinuing antipsychotics once a favourable response has been achieved would be highly desirable, the reality is that no current strategies can realistically be expected to achieve this goal.”  34

    Withdrawal from, change of medication or dosage of psychiatric drugs can result in serious side effects. Please only do so under the supervision of a competent medical doctor

    Further references:

    1. Michael Rosenbloom. Chlorpromazine and the Psychopharmacologic Revolution. JAMA. 2002.
    2. Joanna moncrieff. Long-term Antipsychotics – making sense of the evidence 2013
    3. New York Times. 2012. Phony Diagnoses Hide High Rates of Drugging at Nursing Homes
    4. Michael Rosenbloom. Chlorpromazine and the Psychopharmacologic Revolution. JAMA. 2002.
    5. New York Times. 2012. Phony Diagnoses Hide High Rates of Drugging at Nursing Homes
    6. Kerrie Westaway, et al. The extent of antipsychotic use in Australian residential aged care facilities and interventions shown to be effective in reducing antipsychotic use: A Iiterature review 2018
    7. Michael Rosenbloom. Chlorpromazine and the Psychopharmacologic Revolution. JAMA. 2002.
    8. Flavio Guzman. First vs Second-Generation Antipsychotics. Psychopharmacology Institute.
    9. John Muench. Ann M Hamer. Adverse Effects of Antipsychotic Medications. American Family Physician. 2010.
    10. Fernando Espi Forcen, Konstantina Matsoukas and Yesne Alici. Antipsychotic-induced akathisia in delirium: A systematic review Palliative & supportive care vol. 14,1. 2016. 
    11. Haitham Salem, Caesa Nagpal, Teresa Pigott and Antonio Lucio Teixeiraa. Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges Curr Neuropharmacol. 2017. 
    12. Julie Stewart. Everyday Health. 1 in 4 People Who Take Antipsychotics Long Term Experience This Side Effect
    13. Maren Carbon, Cheng-Hsi Hsieh, John M. Kane and Christoph U. Correll. Tardive Dyskinesia Prevalence in the Period of Second-Generation Antipsychotic Use: A Meta-Analysis. The Journal of Clinical Psychiatry​. 2017.
    14. Davide Martino, Vikram Karnik, Sydney Osland, Thomas R. E. Barnes and Tamara M. Pringsheim. Movement Disorders Associated With Antipsychotic Medication in People With Schizophrenia: An Overview of Cochrane Reviews and Meta-Analysis. The Canadian Journal of Psychiatry. 2018.
    15. Lydia E. Pieters, P. Roberto Bakker and Peter N. van Harten. Asymmetric Drug-Induced Parkinsonism and Psychopathology: A Prospective Naturalistic Study in Long-Stay Psychiatric Patients Front. Psychiatry. 2018.
    16. Shin HW, Chung SJ. Drug-Induced Parkinsonism J Clin Neurol. 2012.
    17. Healthline. What Causes Drug-Induced Parkinsonism?
    18. T. Scott Stroup and Neil Gray. Management of common adverse effects of antipsychotic medications World Psychiatry. 2018.
    19. Tural Hesapcioglu S, Ceylan MF, Kandemir G, Kasak M, Sen CP, Correll CU. Frequency and Correlates of Acute Dystonic Reactions After Antipsychotic Initiation in 441 Children and Adolescents. J Child Adolesc Psychopharmacol. 2020.
    20. Ray WA, Meredith S, Thapa PB, Meador KG, Hall K, Murray KT. Antipsychotics and the Risk of Sudden Cardiac Death. Arch Gen Psychiatry. 2001
    21. T. Scott Stroup and Neil Gray. Management of common adverse effects of antipsychotic medications World Psychiatry. 2018.
    22. WebMD. What Is Neuroleptic Malignant Syndrome?
    23. Ashish Sarangi, Sabiha Armin, Aurelio Vargas, Victoria M. Chu, Kristen Fain & Jessica Nelson. Management of constipation in patients with schizophrenia—a case study and review of literature. Middle East Current Psychiatry . 2021.
    24. Dayabandara M, Hanwella R, Ratnatunga S, Seneviratne S, Suraweera C, de Silva VA. Antipsychotic-associated weight gain: management strategies and impact on treatment adherence Neuropsychiatr Dis Treat. 2017
    25. Park YW, Kim Y, Lee JH. Antipsychotic-induced sexual dysfunction and its management. World J Mens Health. 2012.
    26. Murke MP, Gajbhiye SM, Amritwar AU, Gautam SR. Study of menstrual irregularities in patients receiving antipsychotic medications. Indian J Psychiatry. 2011
    27. Miller DD. Atypical antipsychotics: sleep, sedation, and efficacy. Prim Care Companion J Clin Psychiatry. 2004..
    28. Fadi T. Khasawneh and Gollapudi S. Shankar. Minimizing Cardiovascular Adverse Effects of Atypical Antipsychotic Drugs in Patients with Schizophrenia. Cardiology Research and Practice. 2014.
    29. T. Scott Stroup and Neil Gray. Management of common adverse effects of antipsychotic medications World Psychiatry. 2018.
    30. J Sweeney. The Long-Term Effect of Schizophrenia on the Brain: Dementia Praecox? American Journal of Psychiatry. 2013.
    31. Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry. 201
    32. FDA. 4.11.2005. Public Health Advisory: Deaths with Antipsychotics in Elderly Patients with Behavioral Disturbances.
    33. T. Scott Stroup and Neil Gray. Management of common adverse effects of antipsychotic medications World Psychiatry. 2018.
    34. Emsley R. Antipsychotic maintenance treatment in schizophrenia and the importance of preventing relapse. World Psychiatry. 2018.