A/28. 2nd generation (“atypical”) antipsychotic agents

Question 1

Drugs need to know in this topic

Answer 1

clozapine

olanzapine

quetiapine

risperidone

tiapride

aripiprazole

cariprazine

Question 2

Atypical antipsychotic agents (2nd gen’)

Characteristics

Answer 2

1. 5-HT blockade is the dominant mechanism of action for most atypical agents
2. Beneficial effects on both positive and negative symptoms
3. Metabolic syndrome (weight gain, diabetes, dyslipidemia) is a common side effects of most agents (*olanzapine and clozapine most potent)
4. Reduced risk to develop extra-pyramidal symptoms, hyperprolactinemia and NMS (compared to typical agents)

Question 3

Clozapine

Answer 3

weak D2, stronger D4 and 5-HT2

Myocarditis

Seizures

Agranulocytosis

Weight gain, metabolic effects (dyslipidemia, hyperglycemia)

Question 4

Olanzapine

Answer 4

1. Improves negative symptoms
2. Weight gain, metabolic effects (dyslipidemia, hyperglycemia)

Question 5

Quetiapine

Answer 5

Partial agonist of 5-HT1A receptors

Question 6

Risperidone

Answer 6

1. Improves negative symptoms
2. Significant risk for EPS

Question 7

Tiapride

Answer 7

Atypical antipsychotic,

D2/D3 antagonist;

used in the management of alcohol psychosis

Question 8

Aripiprazole

Answer 8

1. Partial agonist of D2 receptors
2. Partial agonist of 5-HT1A receptors

Question 9

Cariprazine

Answer 9

Atypical antipsychotic,

D2/D3 antagonist;

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