Antipsychotics Flashcards
Indications for use of antipsychotics?
- Schizophrenia
- Schizoaffective disorder
- Bipolar disorder
- Psychotic depression
- Treatment resistant depressive and anxiety disorders
Where do negative symptoms and cognitive disorders arise?
Mesocortical pathway (brainstem to cerebral cortex) Too little dopamine here
Where do positive symptoms arise?
Mesolimbic pathway (dopaminergic cell bodies in ventral tegmentum to limbic system) Too much dopamine here
Which pathway produces parkinsonian movements when there is dopamine hypoactivity?
Nigrostriatal pathway (dopaminergic cell bodies in substantia nigra to the basal ganglia)
Blocking dopamine in what pathway can cause hyperprolactinaemia?
Tuberoinfundibular pathway
hypothalamus to AP
What are typical antipsychotics, any side effects?
D2 dopamine receptor antagonists
Examples of high potency typical antipsychotics and any side effects?
Fluphenazine, haloperidol, pimozide
High affinity to receptors so risk of extrapyramidal side effects
Examples of low potency typical antipsychotics and any side effects?
Chlorpromazine
Less affinity for D2, interact with nondopaminergic receptors > cardiotoxic, sedation, hypotension ect
What are atypical antipsychotics?
Serotonin dopamine 2 antagonists (SDAs)
Side effects of risperidone?
- Extrapyramidal side effectst (dose dependant)
- Most likely atypical to induce hyperprolactinemia
- Weight gain and sedation
Side effects of olanzapine
- Intensive weight gain
- Mess with lipids (hypertriglyceridemia, hypercholesterolemia, hyperglycemia)
- Hyperprolactinemia (
Side effects of Quetiapine
- May cause abnormal LFTs
- Weight gain (
Side effects of aripiprazole?
- Low EPS, no QT prolongation, low sedation
Management if treatment resistant?
Clozapine
Side effects of clozapine?
- Agranulocytosis so requires weekly bloods x 6mths then 2weeks x 6mths
- Inc risk of seizures (especially if used with lithium)
- Sedation, weight gain and abnormal LFTs
- Messes with lipids
