What type of symptoms do first-generation antipsychotics primarily improve?

First-generation antipsychotics, also known as typical antipsychotics, are primarily effective in alleviating positive symptoms of schizophrenia and other psychotic disorders. Positive symptoms include hallucinations, delusions, and disorganized thinking, which reflect an excess or distortion of normal functions. These medications work primarily by blocking dopamine D2 receptors in the brain, particularly in areas associated with these symptoms.

While they may have some effects on other symptom domains, such as negative symptoms (which include lack of motivation, emotional flatness, and social withdrawal), first-generation antipsychotics are not as effective for this purpose. Negative symptoms and cognitive impairments are typically more resistant to treatment with these medications, often necessitating the use of second-generation antipsychotics, which have a broader spectrum of efficacy. Therefore, the major benefit of first-generation antipsychotics lies in their improvement of positive symptoms, making them a cornerstone of treatment for acute episodes of psychosis.