The Medication Corner

Keeping Pace with Changes in Antipsychotic Treatment

By Debra Stokan, M.D.

In the world of psychiatry, the class of medications named “antipsychotics” is used to treat a variety of target symptoms. Antipsychotics are crucial in treating schizophrenia, which is defined by the presence of psychotic symptoms. Such symptoms include auditory and visual hallucinations and paranoia, as well as disorganized and/or aggressive behaviors. The antipsychotics are also helpful in treating the acute episodes of Bipolar Disorder and Major Depressive Disorder. In child psychiatry, antipsychotics such as Risperdal have long been used in disorders such as Tourette’s Syndrome to decrease tics, Autistic Disorder, and Behavior Disorders to decrease impulsive aggression.

Over the years, the medications classified as antipsychotics have become safer with fewer side effects. This past November, a new atypical antipsychotic, Abilify, was given conditional approval by the FDA. It is now available in the United States. As mentioned above, this could be an exciting new treatment option for a number of different psychiatric illnesses.

Abilify (or aripiprazole) has been touted as a “unique” antipsychotic in that its manufacturer believes it could help to regulate dopamine through either increasing or decreasing D₂ receptor activity when needed. In theory, this would treat the symptoms of schizophrenia more effectively. When in an acute psychotic state, the D₂ receptor activity would be decreased. If little or no dopamine is present, Abilify reportedly increases D₂ receptor activity. This latter effect would work to decrease the debilitating “negative” symptoms of schizophrenia, such as amotivation, ambivalence, social withdrawal, and lack of affect or expression.