Ever since the discovery of Thorazine in the early 1950s, antipsychotics have been used extensively in helping to rapidly control the symptoms of acute mania, whether or not there are psychotic symptoms. Their sedating qualities come on fast, and many can be given either by mouth, through an injection, or intravenously.
It’s common practice in emergency rooms and on inpatient psychiatric units when working with a person who is severely agitated, manic, or psychotic, to use a combination of medicines such as haloperidol (Haldol) and a valium-family medication such as lorazepam (Ativan) to rapidly diminish symptoms. This will typically leave the person sedated and calm in a matter of minutes.
While the tranquilizing effects work fast, the ability of these medications to decrease psychotic symptoms (hallucinations, delusions, and disorganized thinking) occurs over the course of weeks.
Just as antipsychotic medication can be helpful in acute mania, they also play a role in the treatment of acute depression, especially depression accompanied by psychotic symptoms. In recent years, two of the atypical antipsychotics received FDA approval for the use in bipolar depression: quetiapine (Seroquel) and the combination pill Symbyax luoxetine/olanzapine (Prozac/Zyprexa).