First-generation antipsychotics (FGAs), also known as typical antipsychotics, are the original performers in the psychiatric pharmacology stage. These agents primarily work by blocking dopamine D2 receptors, which helps reduce positive symptoms of psychosis like hallucinations and delusions. Think of them as the veterans of psychiatric care—effective, but not without a dramatic side.
While FGAs like haloperidol, chlorpromazine, and fluphenazine remain valuable, they come with notable risks, especially extrapyramidal symptoms (EPS), tardive dyskinesia, and neuroleptic malignant syndrome. This section helps psychiatric NPs understand where FGAs still fit in modern treatment plans, how to monitor side effects, and when to consider them over second-generation options. Balancing efficacy with safety is the key to casting these classics in the right role.