Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (856 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia; senile dementia; transient psychosis following surgery; or myocardial infarction; etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Tranquilizing Agents, Major; Major Tranquilizing Agents; Tranquillizing Agents, Major; Major Tranquillizing Agents; Major Tranquilizer; Tranquilizer, Major; Antipsychotic Drug; Drug, Antipsychotic.
Where it fits in the MeSH classification
- Broader topics
- Tranquilizing Agents
- See also
- Dopamine Antagonists
Related concepts
- Schizophrenia
- Myocardial Infarction
Research landscape
PubMed indexes 63,881 records tagged with the MeSH heading “Antipsychotic Agents” (counts retrieved 2026-10-29). 10,069 of them (15.8%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 19,632 records.
Reviews account for 12,395 records (19.4%) and meta-analyses for 1,464. Randomized controlled trials number 4,316 (6.8%) as a share of all records on the topic.
Show the data
| Period | Records |
|---|---|
| through 1999 | 15,808 |
| 2000-2009 | 18,372 |
| 2010-2019 | 19,632 |
| 2020 onward | 10,069 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 12,395 | 19.4% |
| Meta-analyses | 1,464 | 2.3% |
| Randomized controlled trials | 4,316 | 6.8% |
Method: PubMed query "Antipsychotic Agents"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in pharmacology
Drug evidence builds in layers: laboratory pharmacology describes how a compound acts, pharmacokinetic studies describe how the body handles it, and randomized trials test whether it helps and what harms it causes. Post-marketing surveillance and observational studies reveal rarer adverse effects but cannot prove causation. This page is educational and is not a recommendation to start, stop or change any medicine; decisions about treatment belong with a qualified clinician.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Oral Medications for Treating Agitation in a Safety Net Emergency Department | 2025 | Research article Design not recorded in structured metadata | 4 | cc by PMID 41468014 · DOI · PMC12754681 |
| Mechanistic Modeling of Intramuscular Administration of a Long-acting Injectable Accounting for Tissue Response At the Depot Site | 2025 | Research article Design not recorded in structured metadata | 4 | cc by PMID 41136823 · DOI · PMC12591097 |
| The Impact of Sex and Age on Antipsychotic Serum Concentrations | 2026 | Research article Design not recorded in structured metadata | 3 | cc by PMID 41863380 · DOI · PMC13005119 |
Oral Medications for Treating Agitation in a Safety Net Emergency Department [1]
Abstract reading summary — source excerpts
- Opening excerpt
- ImportanceBest-practice guidelines recommend oral medications for treating agitation in the emergency department (ED).
- Closing excerpt
- These data support best-practice guidelines that suggest oral medications should be first-line treatment for agitation in the ED.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (420 words)
ImportanceBest-practice guidelines recommend oral medications for treating agitation in the emergency department (ED). However, there is limited study of their use in the ED, especially in the setting of drug and alcohol intoxication.ObjectiveTo evaluate the implementation of oral medications to treat agitation in an ED in which intramuscular medications were standard and to increase the use of oral medications to treat agitation.Design, setting, and participantsThis quality improvement study analyzed 2 populations. First, all ED patients in an urban level 1 adult and pediatric trauma center from January 1, 2018, to May 31, 2024, were studied to compare the preintervention and postintervention periods. Second, during the 12-month implementation period from September 16, 2020, to August 31, 2021, patients were prospectively observed in an area of the ED dedicated to caring for patients with drug and alcohol intoxication.ExposureOral medications to treat agitation, including olanzapine and lorazepam, were encouraged via education and real-time feedback for ED staff.Main outcomes and measuresThe primary outcome was the proportion of patients receiving their first sedating medication via the oral route. Secondary outcomes included data on time to adequate sedation and adverse drug events.ResultsOf 460 600 ED encounters (median patient age, 38 years [IQR, 27-55 years]; 57.8% men; 184 050 [40.0%] before the intervention, 276 550 [60.0%] after), the proportion of patients receiving any sedating medication was similar between time periods (11.8% before intervention vs 11.5% after). The proportion of patients receiving their first sedating medication via the oral route increased after the intervention (7.2% vs 31.4%; difference, 24.2 percentage points [pp] [95% CI, 23.6-24.8 pp]). Among 1178 patients receiving sedating medications during implementation (860 [73.0%] with alcohol intoxication; median breath or blood concentration, 0.22% [IQR, 0.16%-0.28%]), 630 (53.5%) were offered oral medication, of whom 446 (70.8%) accepted it. Time to adequate sedation was 15 minutes (IQR, 7-33 minutes) for oral and 15 minutes (IQR, 9-26 minutes) for intramuscular medications (median difference, 1 minute [95% CI, -0.6 to 2.6 minutes]). There were no significant differences between routes in rates of additional rescue medications (oral, 31.8%; intramuscular, 28.4%; difference, 3.4 pp [95% CI, -2.0 to 8.8 pp]) or adverse drug reactions (oral, 2.7%; intramuscular, 1.1%; difference, 1.6 pp [95% CI, -0.1 to 3.3 pp]).Conclusions and relevanceIn this quality improvement study, emergency physicians successfully adopted oral medications for treating agitation, primarily from intoxication. No difference was found in time to adequate sedation when oral or intramuscular medications were used as primary therapy. These data support best-practice guidelines that suggest oral medications should be first-line treatment for agitation in the ED.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41468014 · DOI · PMC12754681
Mechanistic Modeling of Intramuscular Administration of a Long-acting Injectable Accounting for Tissue Response At the Depot Site [2]
Abstract reading summary — source excerpts
- Opening excerpt
- The tissue response to long-acting injectables (LAIs) suspension injection may impact the product in vivo performance.
- Closing excerpt
- This shows the utility of physiologically based pharmacokinetic (PBPK) model in mechanistically describing the in vivo performance of LAIs.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (242 words)
The tissue response to long-acting injectables (LAIs) suspension injection may impact the product in vivo performance. One such response is the formation of an inflammatory cell layer (ICL) resulting in an envelope around the injected particles. This study aims to use a mechanistic model to describe the clinical in vivo exposure and performance of an intramuscular LAI suspension and evaluate impact of ICL physiological response at the injection site in humans. Aripiprazole lauroxil (AR-L) was used as the model drug. A baseline pharmacokinetics model was built and validated for aripiprazole. The impact of inflammation on the LAI in vivo performance was assessed by including an ICL model. The developed pharmacokinetic model adequately described the observed plasma profiles of AR following intravenous and oral administration in humans. The initial intramuscular predictions assumed that the absorption rate is dependent on the dissolution and partitioning of AR-L into the systemic circulation from the intramuscular (IM) depot. The simulation resulted in a shape mismatch between the simulated and observed data and an earlier predicted Tmax. The inclusion of an ICL in the model resulted in adequate predictions (fold errors less than 25%) of the exposure and shape of the plasma concentration-time profiles. Utilizing a time-dependent change in ICL thickness resulted in reasonable predictions of AR pharmacokinetic profiles following IM administration of multiple strengths of the AR-L suspension. This shows the utility of physiologically based pharmacokinetic (PBPK) model in mechanistically describing the in vivo performance of LAIs.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41136823 · DOI · PMC12591097
The Impact of Sex and Age on Antipsychotic Serum Concentrations [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Background and hypothesisEstrogen affects drug metabolism for specific antipsychotics, which may produce sex differences in serum levels, especially over the menopausal transition.
- Closing excerpt
- Our findings suggest that monitoring antipsychotic levels may add clinical value and underscore the need for sex-specific prescription guidelines for olanzapine and clozapine.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (194 words)
Background and hypothesisEstrogen affects drug metabolism for specific antipsychotics, which may produce sex differences in serum levels, especially over the menopausal transition. Here, we explore sex differences in concentrations of four commonly used antipsychotics: clozapine, olanzapine, aripiprazole, and quetiapine and examined how these vary across age groups, including postmenopause (>55).Study designAntipsychotic concentrations of 44 378 serum samples drawn between January 2016 and October 2024 were analyzed. Samples were provided by 6147 unique adult men and women for clozapine (n = 34 761 samples, 26% female), olanzapine (n = 5114, 27% female), aripiprazole (n = 3171, 37% female), and quetiapine (n = 1332, 50% female). To investigate the effect of sex and age on antipsychotic concentrations, we employed linear mixed-effects models and pairwise contrasts by dividing the samples in 6 groups according to sex and age (55 years).Study resultsWe found higher concentrations in women compared to men for clozapine (P 55 years (all P ConclusionsWe found sex differences in olanzapine and clozapine concentrations, which were most pronounced until 45 years of age. Our findings suggest that monitoring antipsychotic levels may add clinical value and underscore the need for sex-specific prescription guidelines for olanzapine and clozapine.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41863380 · DOI · PMC13005119
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis [4]
- Research article Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre-post studies [5]
- Research article Rates of treatment-resistant schizophrenia from first-episode cohorts: systematic review and meta-analysis [6]
- Research article Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia [7]
- Research article Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis [8]
- Research article Update on weight-gain caused by antipsychotics: a systematic review and meta-analysis [9]
References
- Cole JB, Hurreh KM, Taghizadeh LA, Laudenbach AP, Olives TD, Miner JR, et al.. Oral Medications for Treating Agitation in a Safety Net Emergency Department. . 2025. PMID 41468014 · DOI · PMC12754681
- Silva DA, Le Merdy M, Mullin J, Malavia N, Alam K, Tsakalozou E, et al.. Mechanistic Modeling of Intramuscular Administration of a Long-acting Injectable Accounting for Tissue Response At the Depot Site. . 2025. PMID 41136823 · DOI · PMC12591097
- de Beer F, Brand BA, Wijnen B, Gangadin SS, Schoretsanitis G, Touw D, et al.. The Impact of Sex and Age on Antipsychotic Serum Concentrations. . 2026. PMID 41863380 · DOI · PMC13005119
- Huhn M, Nikolakopoulou A, Schneider-Thoma J, Krause M, Samara M, Peter N, et al.. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet. 2019. PMID 31303314 · DOI · PMC6891890
- Kishimoto T, Hagi K, Kurokawa S, Kane JM, Correll CU. Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre-post studies. Lancet Psychiatry. 2021. PMID 33862018 · DOI
- Siskind D, Orr S, Sinha S, Yu O, Brijball B, Warren N, et al.. Rates of treatment-resistant schizophrenia from first-episode cohorts: systematic review and meta-analysis. Br J Psychiatry. 2022. PMID 35049446 · DOI
- Leucht S, Crippa A, Siafis S, Patel MX, Orsini N, Davis JM. Dose-Response Meta-Analysis of Antipsychotic Drugs for Acute Schizophrenia. Am J Psychiatry. 2020. PMID 31838873 · DOI
- Schneider-Thoma J, Chalkou K, Dörries C, Bighelli I, Ceraso A, Huhn M, et al.. Comparative efficacy and tolerability of 32 oral and long-acting injectable antipsychotics for the maintenance treatment of adults with schizophrenia: a systematic review and network meta-analysis. Lancet. 2022. PMID 35219395 · DOI
- Barton BB, Segger F, Fischer K, Obermeier M, Musil R. Update on weight-gain caused by antipsychotics: a systematic review and meta-analysis. Expert Opin Drug Saf. 2020. PMID 31952459 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.