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Antipsychotic Medication

Side Effects:

Indications:
Uses: Schizophrenia, Schizoaffective Disorder, Mania,
Psychotic Depression, Toxic Psychosis, Tourettes
syndrome

Mechanism:

THE BASAL GANGLIA

D2-Dopamine Receptor
Blockade

Antipsychotic medication, can be classified as two types. Typical (First


Generation) and Atypical (Second Generation).
Typical antipsychotics work blocking D1 and D2 dopamine receptors.
This causes reduction in the positive symptoms of schizophrenia. Some
of the older drugs (e.g. phenothiazines) are relatively non-selective,
whereas sulpiride and amisulpiride are highly selective for D2 dopamine
receptors in the mesolimbic pathway. They also block cholinergic,
adrenergic and histaminergic receptors. Typical antipsychotics are more
likely than atypicals to cause extra-pyramidal movement disorders and
raised prolactin which causes endocrine effects.

THE PITUITARY GLAND

E.P.S.E (Movement
Disorders) Niagrostriatal
Pathway :
Parkinsonism
Akathisia
Dystonia
Tardive dyskinesia

Atypical antipsychotics also block dopamine receptors, usually with a


lower affinity, and are 5HT2 antagonists. They can be more effective at
reducing negative symptoms as well as well as positive symptoms of
schizophrenia, particularly Clozapine and amisulpiride.

Positive
Negative
Symptoms of symptoms of
Schizophrenia Schizophrenia

First
Generation
typical
antipsychotics

Second
Generation
atypical
antipsychotics

Hallucinations

Haloperidol

Rispiradone

Delusions
Thought
disorder

Social
Withdrawal
Lack of
motivation
Anhedonia

Chlorpromazine

Olanzapine

Fluphenazine

Sulpiride

Perphenazine

Quitiapine

Trifluoperazine

Aripiprazole

Thioridazine

Clozapine

Endocrine Effects:
Increased Prolactin
Tuberoinfundibular
pathway
Gynaecomastia
Galactorrhoea
Menstrual Irregularities
Impotence
Weight gain

Other Receptor
Blockade:

Important
Contraindication:
Atypicals not
recommended for treating
violent/agitated symptoms
in elderly patients with
dementia due to increased
risk of stroke and
impairment of glycaemic
control

Autonomic effects:
-adrenorecptors
Postural hypotension
Failure of ejaculation
Hypothermia
Anti-muscarinic:
Dry mouth
Urinary retention
Constipation
Blurred vision
Antihistaminergic
Drowsiness
Cardiac:
Prolonged QT interval
Toxic:
Neuroleptic Malignant
Syndrome