Drugs - Antipsychotic - Atypical 03

Question 1

What is the potency of ziprasidone?

Answer 1

Very potent 5HT2A and D2 blocker (similar to risperidone)

Question 2

What is unique about ziprasidone?

Answer 2

Potent norepinephrine and serotonin reuptake inhibitor

Question 3

What are the contraindications of ziprasidone?

Answer 3

Contraindicated with any other agent that prolongs the QT interval

Question 4

What is the advantage of ziprasidone?

Answer 4

Less weight gain

Question 5

What is the method of action of aripiprazole?

Answer 5

It is a partial agonist at the D2 receptors (functionally is a partial antagonist in mesolimbic system were dopamine levels are excessive so it decreases positive symptoms), and has a partial agonist at postsynaptic D2 receptors in the striatum so you get less EPS. It also blocks 5HT2A receptors so it is effective in treating negative symptoms

Question 6

What are the side effects of aripiprazole?

Answer 6

Nausea and vomiting due to partial D2 agonism in the CTZ, insomnia

Question 7

Which atypical antipsychotic has the least weight gain, hyperglycemia, hyperlipidemia, and hyperprolactemia?

Answer 7

Aripiprazole

Question 8

What is the goal of antipsychotic therapy?

Answer 8

To block approximately 70% of the D2 like receptors in the mesolimbic system (nucleus accumbens, etc) because a greater occupation of these receptors tends to suppress behavior too much.

Question 9

What is the advantage of aripiprazole over dopamine?

Answer 9

Aripiprazole being a partial agonist at the D2 receptors will also provide a measure of stimulation to mesolimbic D2 receptors but still will prevent excessive stimulation of these receptors by the full agonist dopamine.

Question 10

What happens when you have greater than 78% occupancy of the striatal D2 receptors?

Answer 10

EPS

Question 11

What do some clinicians refer to aripiprazole as?

Answer 11

A dopamine system stabilizer (DSS)