Atypical antipsychotics have decreased incidence of extrapyramidal side effects compared to antipsychotics in general. Are also used for autism.

Low dose quetiapine is used for sleep and sometimes for anxiety.

Antipsychotics were once used for the nausea of pregnancy because they are effective anti-nausea agents.

Antipsychotics are sometimes used for agitation (in dementia for instance) and for aggressive behavior, sometimes in children.

Antipsychotics are used for psychosis in general - drug and alcohol-induced, affective, steroid or L-dopa induced, delirium, delusional states, metabolic, endocrine or neurologic psychosis.

Antipsychotics are used as adjuncts to antidepressants.

Antipsychotics are used for hypomania.

Metaclopramide (which is a mild antipsychotic) used to be used - maybe still is - for digestive problems.

These drugs ought not to be used to treat anything except psychosis. They have serious side effects if used long term and there are safer drugs that can be substituted.

Atypical antipsychotics can be used as mood stabilisers agent in acute phase of manic episode.

Antisychotics in low doses can be used cautiously for short term use in acte behavioural disturbances due to dementia (avoids in Lewy body dementia)

According my experience as family doctor, in primary care the main uses of antipsychotic drugs, beyond their indication in schizophrenia and other psychotic disorders, are two:

(a) as sedative agents in the symptomatic treatment of some behavioral disorders in patients with dementia

(b) to enhance (augment) the effect of antidepressant treatment on resistent unipolar depression

Of course, also in bipolar depression, drug addictions, personality disorders, etc.

Sorely, use of anti-psychotics, especially atypical/novel anti-psychotics, is currently rampant and is largely off-label driven. In fact, these are 'broad-spectrum' psychotropic agents but the indiscriminate use is plagued with heinous cardio-metabolic and for the older conventional group, neuro-hormonal side effects. As the name implies they are indicated in- Psychosis

1) functional psychoses-Schizophrenia, delusional disorder, etc

2) Mood stabilizers- in bipolar mood disorder

3) Organic psychoses- e.g. TBI

4) Toxic psychosis- with substance use disorders e.g. during intoxication

5) Delirium- including prophylactic use

6) Dementia- for BPSD= behavioural psychological symptoms of dementia despite black-box warnings

7) Augmentation in MDD, OCD, anxiety disorders

8) Borderline Personality disorder e.g. for affective dysregulation and micropsychotic spells

9) Anorexia Nervosa

10) PTSD- esp complex cases

11) Insominia- e.g. low dose Seroquel

12) Tourette Syndrome

13) Irritability in Autism Spectrum Disorders

14) Aggression (non-specific)-e.g. ER setting, in neurobehavioural syndrome in Intellectual disability, conduct disorder, ADHD, sort of a chemical restraint...

15) Others- e.g. antiemetic as chlorpromazine

This list is by no means all-inclusive.

Ahmed Naguy Very punctual and precise your analysis and surely I agree with you, but we've to recommend that the main indication of antipsychotics is Schizophrenia and Bipolar Disorder.

To be used with caution in other indications because off-label, even if we know how to be effective (e.g. In Italy the only drug approved in treatment of bulimic eating disorders is fluoxetine. All other drugs if used are off-label)

Antipsychotic medications can be used in management of

1. bipolar disorder

2. Behavioural problems (aggression) associated with autism, dementia, mental retardation

3. Depressive episode with psychotic symptoms

4. As a augmenting agent to antidepressants in resistant depression and resistant OCD

5.Tic disorder