Phenothiazine antipsychotics are a type of medicine used to treat psychiatric diseases, specifically schizophrenia and associated psychotic conditions. These medications are distinguished by their chemical structure, which includes a tricyclic ring system including a sulfur atom. The prototype for this family is chlorpromazine, which was discovered in the 1950s and transformed the treatment of severe mental diseases. Phenothiazines achieve their therapeutic effects by inhibiting dopamine receptors in the brain. Dopamine is a neurotransmitter connected with mood modulation, and imbalances in its levels have been linked to psychotic illnesses. Phenothiazines, which antagonize dopamine receptors, serve to reduce symptoms such as hallucinations, delusions and cognitive problems. Aside from inhibiting dopamine, phenothiazines interact with other neurotransmitter systems such as serotonin and norepinephrine. This larger pharmacological profile helps to explain their efficacy in treating a variety of mental symptoms. Phenothiazines are known to cause drowsiness, weight gain, and anticholinergic symptoms such as dry mouth and blurred vision. Extrapyramidal symptoms (EPS), which include muscle rigidity, tremors, and restlessness, may also develop. To combat EPS, antipsychotic medicines such as phenothiazines are frequently used with anticholinergic medications or newer antipsychotics that have a lower risk of EPS. While phenothiazines have played an important role in psychiatric treatment, the introduction of newer antipsychotic medicines has caused a shift in prescribing habits. Second-generation antipsychotics, which have a different receptor profile and may cause less adverse effects, are now commonly used as the first line of treatment. However, phenothiazines are still useful in some clinical contexts, particularly where cost or individual patient response dictate their use. Finally, phenothiazine antipsychotics have long been used to treat serious mental diseases. While newer generations of antipsychotics have developed with distinct profiles, phenothiazines continue to be significant in psychiatric therapy, providing an effective and cost-effective choice for those who may benefit from their distinctive pharmacological features.
