Antipsychotics

Question 1

phenothiazines
MOA: strong D2 antagonists
side effects due to alpha adrenergic, muscarinic and 5-HT receptor blockade

Answer 1

chlorpramazine (thorazine)
fluphenazine (Prolixin)
thioridizine (Mellaril)

Question 2

slightly less potent than phenothiazines

Answer 2

thiothixene (Narvane)

Question 3

more potent than phenothiazines but with fewer side effects

Adverse: severe muscle stiffness

Answer 3

haloperidol

Question 4

Atypical antipsychotics
serotonin-dopamine antagonists
MOA: greater potency for 5-HT2a receptors
Use: negative and positive symptoms of schizophrenia
Mood stabilizers in autism and bipolar disorder
-fewer EPS because don’t bind to D2 receptors with as high affinity as typical antipsychotics
side effect: weight gain from H1 receptor blockade & hypercholesterolemia (first 2 listed)

Answer 4

clozapine
olanzapine
quetiapine
ziprasidone
risperidone
aripiprazole

Question 5

other uses for atypical antipsychotics

Answer 5

acute mania
bipolar disorder
Tourette's syndrome
OCD
control aggression in self-injurious children

Question 6

associated with psychosis

Answer 6

• increased dopaminergic activity in limbic system

- increased D2 receptor density in nucleus accumbens, caudate & putamen (schizophrenia)

Question 7

side effects of antipsychotics

Answer 7

• dopamine release into the portal circulation by the arcuate & PVN decreases prolactin secretion. If inhibit DA neurons will get increased release of prolactin
• tardive dyskinesia (D2 blockade in nigrostriatal pathway)

Question 8

receptors blocked by antipsychotics

Answer 8

D2, alpha, muscarinic, H1 and 5-HT2

Question 9

What makes an antipsychotic atypical?

Answer 9

equal receptor occupancy for D2 and 5-HT2a