Which medications in the drug class Antipsychotics, 1st Generation are used in the treatment of Bipolar Disorder?

Updated: May 30, 2019
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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Antipsychotics, 1st Generation

First-generation antipsychotics, also known as conventional or typical antipsychotics, are efficacious for treating both psychotic and nonpsychotic manic and mixed episodes, as well as hypomania. These agents are strong dopamine D2 antagonists. However, each drug in this class has various effects on other receptors, such as 5-HT2 serotonin, alpha1, histaminic, and muscarinic receptors.

Loxapine (Adasuve)

The mechanism of action for loxapine is unknown, but it is theorized to antagonize central dopamine D2 and serotonin 5-HT2a receptors. The inhaled dosage form is indicated for acute treatment of agitation associated with schizophrenia or bipolar I disorder in adults.

Haloperidol (Haldol)

Haloperidol is used for the acute treatment of mania or mixed episodes in patients with bipolar disorder. It can be used alone or in combination with lithium or valproate in an adult patient. Haloperidol blocks postsynaptic dopamine receptors (D2) in the mesolimbic system and increases dopamine turnover by blockade of the D2 somatodendritic autoreceptor

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