Antipsychotic medications

Question 1

antipsychotic medications for schizophrenia are

Answer 1

equally efficacious but have variable side effects

Question 2

common side effects of antipsychotic medications are

Answer 2

weight gain, metabolic syndrome (obesity, lipid, cholesterol abnormalities, HTN and impaired glucose metabolism) extrapyramidal side effects - acute dystonia, akathisia, parkinsonism, tardative dyskinesia

Question 3

high potency 1st generation antipsychotics

Answer 3

haloperidol and fluphenazine have higher incidence of extrapyramidal side effects less tolerated by pts

Question 4

second generation antipsychotics have less potential

Answer 4

to cause extrapyramidal side effects

Question 5

aripriprazole has the lower potential for

Answer 5

causing weight gain or metabolic syndrome

Question 6

ziprasidone is associated with

Answer 6

less weight gain than aripiprazole but has highest risk for QT prolongation

Question 7

side effect of clozapine

Answer 7

life threatening agranulocytosis and neutropenia

reserved for treatment resistant cases can cause weight gain

Question 8

olanzapine main side effects

Answer 8

causes weight gain and metabolic syndrome

Question 9

Chart comparing the side effect profiles of second generation antipyschotic medications

Answer 9

Question 10

Schizophrenia clinical features and management chart

Answer 10

Question 11

Diagnosis of schizophrenia

Answer 11

ruling out medical and substance induced causes of psychosis and differentiation from other psychotic disorders and mood disorders with psychotic features

Needs >6 months of functioanl decline including >2 of hte following: delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms.

Question 12

delusion disorder vs schizophrenia

Answer 12

delusion disorder is persistent delusion >1 month but doesn’t include any ohter psychotic symptoms or marked functional impairment commonly seen in schizophrenia.

Question 13

cannabis is not the same thing as schizophrenia.

Answer 13

can trigger or exacerbate an underlying psychotic disorder but there is no evidence that sporadic use alone can cuase persistent psychosis.

Question 14

clozapine prescription

Answer 14

done through acentral registry that monitors ANC (abs neutrophil counts) and pts must be told if they have symptoms promptly

If ANC<1000, clozapine should be HELD until ANC>1000

If ANC <500, clozapine should be discontinued PERMANENTLY