What is the most effective symptom type that first generation antipsychotics reduce in schizophrenia?

First-generation antipsychotics, also known as typical antipsychotics, are particularly effective in targeting and reducing positive symptoms of schizophrenia. Positive symptoms are those that represent an excess or distortion of normal functions, such as hallucinations, delusions, and disorganized thinking. These symptoms are directly linked to dopaminergic hyperactivity in certain brain pathways, specifically the mesolimbic pathway, which is where first-generation antipsychotics exert their primary therapeutic effects by blocking dopamine D2 receptors.

This receptor blockade helps to mitigate the experience of hallucinations and delusions, leading to a reduction in the severity of these symptoms for many individuals with schizophrenia. While first-generation antipsychotics may also have some effects on negative, cognitive, and emotional symptoms, their main efficacy has been established in the management of positive symptoms. As a result, they are often first-line treatments for managing acute episodes characterized by these symptoms.