When we talk about first-generation antipsychotic, a class of psychiatric drugs developed in the 1950s to treat psychosis, especially schizophrenia. Also known as typical antipsychotic, these medications were the first real tools doctors had to calm hallucinations, delusions, and severe agitation. Before them, many people with serious mental illness were locked away with little hope. These drugs didn’t cure anything—but they gave people back some control over their minds.
How do they work? Simple: they block dopamine, a brain chemical that gets overactive in psychosis. That’s why drugs like chlorpromazine, the first widely used first-generation antipsychotic, introduced in 1952 and haloperidol, a potent, long-lasting option still used today work so well for acute symptoms. But blocking dopamine doesn’t just help with hallucinations—it messes with movement, mood, and even hormone balance. That’s why so many people on these drugs develop extrapyramidal symptoms, involuntary muscle movements like tremors, stiffness, or restlessness. These side effects aren’t rare. They’re common. And they’re often worse than the psychosis they’re meant to treat.
These drugs aren’t gone. They’re still used—especially in places where newer meds are too expensive or hard to get. Some doctors still reach for them when a patient doesn’t respond to anything else. But today, we know more. We know that first-generation antipsychotic can cause tardive dyskinesia—a movement disorder that might stick around even after stopping the drug. We know they can raise prolactin levels, leading to breast growth, lost sex drive, or missed periods. We know they’re not the best choice for older adults with dementia, where they can increase the risk of stroke or death.
The posts here don’t just list these drugs. They show you the real trade-offs. You’ll find comparisons between older antipsychotics and newer ones, stories of people who suffered side effects, and clear breakdowns of when a first-generation drug might still be the right call. You’ll also see how these meds interact with other drugs—like how combining them with certain heart or stomach meds can trigger dangerous rhythms. This isn’t theory. These are real risks, documented in real cases.
Whether you’re a patient, a caregiver, or just trying to understand why someone’s on a medication that seems to cause more problems than it solves, this collection gives you the facts without the fluff. No marketing. No jargon. Just what works, what doesn’t, and what you need to ask your doctor before starting—or stopping—any of these drugs.
