2nd Generation Antipsychotics Flashcards
Indication
Schizophrenia, bipolar disorder, autism, MDD (adjunctive)
Adverse effects
Lower incidence of EPS and prolactin levels, but higher incidence of metabolic side effects
M1 block - antimuscarinic
H1 block - weight gain
A1 block - QT prolongation, arrhythmia
5-HT2c block - weight gain
Mode of action
Main target: 5-HT2a receptor
Help on both positive and negative symptoms
Lack of EPS
Tricyclic antipsychotic drugs
Clozapine (leponex)
Olanzapine (zyprexa)
Quetiapin (seroquel)
Heterocyclic antipsychotic drugs
Risperidone (risperdal) Paliperidone Lioperidone Ziprazidone Sertindole Lurasidone
New 2nd generation antipsychotic drugs
Lurasidone Amisulprid Tiaprid Aripriprazole Cariprazine
Clozapine (leponex)
D4>5-HT2a/c>M;H1;a1>D2
Oldest 2nd gen drug
No EPS
Can cause agranulocytosis - infections
Cardiotoxicity, hypotension, weight gain, sedation.
Not a first line drug
Olanzapine (zyprexa) and quetiapine (seroquel)
5-HT2a/c>D2>M;H1;a1
Metabolite of quetiapine inhibit NE reuptake
Risperidone (risperdal) and paliperidone
5-HT2a>D2»M;(H1 and a1)
R; suppress aggressively in autistic kids m
P; for psychosis and manic episodes
Lioperidone
A1>5-HT2a/c >D2-D3
Severe hypotension
Ziprasidone
5-HT2a>D2
Strong Na+ channel blocker leading to prolonged QT
High incidence of Parkinsonism
Sertindole
Cardiotoxic
Not first choice
Aripriprazole (abilify)
D2 partial agonist, and 5-HT2a antagonist
Gold standard for child bipolar disorder
May cause akathisia
Works as antagonist
No anti cholinergic effects
More effective for negative symptoms
Cariprazine
D3>D2;5-HT2a
Hungarian drug
For manic episodes
Negative symptoms
