Antipsychotics

Question 1

Chlorpromazine (Thorazine)

Answer 1

MOA: strong D2 antagonist. Helps only with positive symptoms.
Side effects: sedative, extrapyramidal (Involuntary movements (tardive diskinesia), tremors and rididity (parkinsonism), body restlessness (akathisia), muscle contractions (acute dystonia). Antimuscarinic effects, hyperprolactemia, weight gain, cardiovascular (orthostatic hypotension, prolongation of QT interval).

Question 2

Haloperidol (Haldol)

Answer 2

MOA: strong D2 antagonist. Helps only with positive symptoms.
Side effects: sedative, extrapyramidal (Involuntary movements (tardive diskinesia), tremors and rididity (parkinsonism), body restlessness (akathisia), muscle contractions (acute dystonia). Antimuscarinic effects, hyperprolactemia, weight gain, cardiovascular (orthostatic hypotension, prolongation of QT interval).
Higher affinity=High potency=higher risk of EPS side effects.

Question 3

Clozapine (Clorazil)

Answer 3

MOA: Shared 5HT2 and D2 antagonists.
Helps positive and negative symptoms.
Side effects: Sedative, less extrapyramidal, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabeties II). Cardiovascular (less orthostatic hypotension, prolongation of QT interval).
The most effective. The least safe. Least likely to induce tardive dyskinesia.
Bad side effects: Agranuloxytosis, and seizures.

Question 4

Quetiapine (seroquel)

Answer 4

MOA: Shared 5HT2 and D2 antagonists.
Helps positive and negative symptoms.
Side effects: Sedative, less extrapyramidal, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabeties II). Cardiovascular (less orthostatic hypotension, prolongation of QT interval).

Question 5

Olanzapine (Zyprexa)–>best compliance

Answer 5

MOA: Shared 5HT2 and D2 antagonists.
Helps positive and negative symptoms.
Side effects: Sedative, less extrapyramidal, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabeties II). Cardiovascular (less orthostatic hypotension, prolongation of QT interval).

Question 6

Ziprasidone (Geodon)

Answer 6

MOA: Shared 5HT2 and D2 antagonists.
Helps positive and negative symptoms.
Side effects: Sedative, less extrapyramidal, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabeties II). Cardiovascular (less orthostatic hypotension, prolongation of QT interval).

Question 7

Risperidone (Risperdal)

Answer 7

MOA: Shared 5HT2 and D2 antagonists.
Helps positive and negative symptoms.
Side effects: Sedative, less extrapyramidal, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabeties II). Cardiovascular (less orthostatic hypotension, prolongation of QT interval).

Question 8

Aripiprazole (Abilify)–>D2 partial agonist

Answer 8

MOA: Shared 5HT2 and D2 antagonists.
Helps positive and negative symptoms.
Side effects: Sedative, less extrapyramidal, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabeties II). Cardiovascular (less orthostatic hypotension, prolongation of QT interval).

Question 9

Paliperidone (Invega)–> active metabolite of risperidone

Answer 9

MOA: Shared 5HT2 and D2 antagonists.
Helps positive and negative symptoms.
Side effects: Sedative, less extrapyramidal, less antimuscarinic, less hyperprolactemia, metabolic syndrome (obesity, hyperlipidemia, diabeties II). Cardiovascular (less orthostatic hypotension, prolongation of QT interval).