Antipsychotics Flashcards
Chlorpromazine
Thorazine
1st gen
MOA: blocks dopamine 2 receptors; combination of dopamine D2, histamine H1, and cholinergic M1 blockade in the vomiting center may reduce nausea and vomiting
Psychotic symptoms improve within 1 week
Weight gain is common and sedation is a problem
200-800 mg/day
Psychosis: increase flash til symptoms are controlled; after 2 weeks reduce to lowest effective dose
Fluphenazine
Prolixin
1st gen (conventional antipsychotic)
MOA: blocks dopamine 2 receptors
Psychotic symptoms can improve within 1 week
Weight gain and sedation are not unusual (occur in significant minority)
1-20mg/day maintenance
initial 0.5-10mg/day in divided dose, max is 40 mg/day
Haloperidol
Haldol
1st gen (conventional)
MOA:blocks dopamine 2 receptors; blocks dopamine 2 receptors in the nigrostriatal pathway (helping ticks and Tourette’s syndrome)
psychotic symptoms can improve within 1 week
weight gain and sedation are not unusual (occur in significant minority)
1-40 mg/day PO
initial 1-15mg/day; can give once daily or in divided doses at beginning of tx during rapid dose escalation; can be dosed up to 100 mg/day
depot dose:10-20x the oral dose
Perphenazine
1st gen (conventional)
MOA: blocks dopamine 2 receptors, reducing positive symptoms of psychosis; combination of dopamine D2, histamine H1, and cholinergic M1 blockade in the vomiting center may reduce nausea and vomiting
psychotic symptoms can improve within 1 week
weight gain and sedation are common
oral 12-24 mg/day
for psychosis: 4-8 mg tid; max 64 mg/day
Thioridazine
Mellaril
1st gen
Thioridazine
Mellaril
1st gen (conventional)
MOA: blocks dopamine 2 receptors
psychotic symptoms can improve within 1 week
weight gain and sedation are common
200-800 mg/day in divided doses
50-100 mg tid, increase gradually
QT prolongation is dose dependent-start low and go slow
Thiothixene
Navane
1st gen (conventional)
MOA: blocks dopamine 2 receptors
psychotic symptoms can improve within 1 week
weight gain is unusual, sedation is not unusual
15-30 mg/day
initial 5-10 mg/day; maximum dose generally 60 mg/day
Trifluoperazine
Stelazine
1st gen (conventional)
MOA:blocks dopamine 2 receptors
psychotic symptoms can improve within 1 week
weight gain is unusual; sedation is common
oral 15-20 mg/day
initial 2-5 mg twice a day; increase gradually over 2-3 weeks
Asenapine
Saphris
2nd gen
Asenapine
Saphris
2nd gen (also a mood stabilizer)
MOA: blocks dopamine 2 receptors, reducing positive symptoms; blocks serotonin 2A receptors, causing enhancement of dopamine release in certain brain region possibly improving cognitive and affective symptoms
psychotic symptoms can improve within 1 week
weight gain is not unusual; sedation is common
10-20mg/day in 2 divided doses for schizophrenia (all sublingual)
initial 10 mg/day in 2 divided doses, max generally 20mg/day in 2 divided doses
Iloperidone
Fanapt
2nd gen
Clozapine
Clozaril
2nd gen (also a mood stabilizer)
MOA: blocks dopamine 2 receptors, reducing positive symptoms of psychosis .
Lurasidone
Latuda
2nd gen
Olanzapine
Zyprexa
2nd gen
Paliperidone
Invega
