Antipsychotics

Abstract

Neurological disorders are almost always associated with psychiatric symptoms because disrupting neural pathways disrupt the circuitry that underlies mental processes. Of all the psychiatric symptoms that neurological lesions can trigger, psychosis is perhaps the most confusing to the patient and alarming to the neurologist due to the seriousness of the symptoms that can range from delusions and hallucinations to bizarre behavior or harm to self or others. While some neurologists refer patients who develop psychotic symptoms to psychiatrists for management, others treat such patients themselves. However, as psychiatrists know well, the management of psychotic disorders goes beyond pharmacotherapy and requires a team approach that can provide the necessary psychosocial interventions and therapies. However, pharmacologic treatment of poor reality testing in psychosis is the most essential first step toward restoring mental and functional stability to a patient. In this chapter, an overview of the four generations of antipsychotics is provided for neurologists to enable them to initiate the treatment of psychosis in their neurological practice and refer the patient as needed for longer-term management in a psychiatric setting.