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ANTIPSYCHOTICS

Atypical
Drugs Clozaril (clozapine) Risperdal (risperidone) Zyprexa (olanzepine) Seroquel (quetiapine) Geodon (ziprasidone) Abilify (aripiprazole) Invega (paliperidone) Block postsynaptic dopamine receptors in the basal ganglia, hypothalamus, limbic system, brainstem and medulla. These medications also affect serotonin levels. Treatment of hallucinations and delusions (psychotic symptoms). They may also be seen in bipolar disorder, major depression, and delusional disorder. Treatment of the negative symptoms of schizophrenia, e.g. flat affect, apathy, lack of motivation, social withdrawal. Reduction in aggressive behavior. Augmentation of antidepressant and antimanic medications. Side or Adverse Effects Extrapyramidal side effects (EPS) see description below ** much less than the Typical Sedation Anticholinergic effects see description below ** much less than the Typical Weight gain Photosensitivity Decreased Seizure threshold Orthostatic hypotension Galactorrhea/amenorrhea Sexual dysfunction Neuroleptic Malignant Syndrome (NMS) see description below CNS depressants like alcohol have additive depressant effects when given with these drugs. Cigarette smoking causes reduced plasma concentrations of some atypical antipsychotics Beta-blockers given with atypical antipsychotics can cause severe hypotension Anti-depressants in conjunction with antipsychotics may cause increased blood concentration of the antidepressant SSRIs in conjunction with atypical antipsychotics may cause sudden onset of extrapyramidal symptoms (EPS).

Typical
Haldol (haloperidol) Prolixin (fluphenazine) Trilafon (perphenazine) Stelazine (trifluoperazine) Navane (thiothixene) Thorazine (Chlorpromazine) Blocks post-synaptic Dopamine-2 (D2) receptors in the basal ganglia, hypothalamus, limbic system, brainstem, and medulla.

Action

Intended Effect

Side Effects

Toxic Effects Contraindications

Teaching

Treatment of hallucinations and delusions (psychotic symptoms). They may also be seen in bipolar disorder, major depression, and delusional disorder. Treatment of tics, vomiting, and intractable hiccups. Reduction in aggressive behavior ** These drugs are not very helpful with negative symptoms. Side or Adverse Effects Extrapyramidal side effects (EPS) see description below Sedation Anticholinergic effects see description below Weight gain Photosensitivity Decreased Seizure threshold Orthostatic hypotension Galactorrhea/amenorrhea Sexual dysfunction Neuroleptic Malignant Syndrome (NMS) see description below CNS depressants like alcohol have additive depressant effects when given with these drugs. Cigarette smoking causes reduced plasma concentrations of some atypical antipsychotics Beta-blockers given with atypical antipsychotics can cause severe hypotension Anti-depressants in conjunction with antipsychotics may cause increased blood concentration of the antidepressant SSRIs in conjunction with atypical antipsychotics may cause sudden onset of extrapyramidal symptoms (EPS). Regular administration of antipsychotic medications Taking these drugs regularly will can prevent exacerbations of psychosis. prevent recurrence of psychotic and Those taking clozapine must have their blood counts other symptoms. Failure to take antimonitored frequently because the drug may cause psychotics as prescribed can lead to bone marrow toxicity relapses and repeated hospitalizations. Risperdal is available in a depot preparation, and Doses should be lowered for the elderly may be more effective in this form, especially in Haldol and Prolixin are available in those having problems adhering to their oral depot preparations, and may be more regimens. effective in this form, especially in those having problems adhering to their oral regimens.