Antipsychotics

Question 1

Haloperidol

Answer 1

MOA: classic ‘typical’ antipsychotic that acts as a D2 antagonist (inhibits the inhibitory Gi)
Adverse effects: Classic antipsychotics experience more motor effects than metabolic effects. Thus, ADRs include: dyskinesia and extrapyramidal effects such as tar dive dyskinesia and neuroleptic malignant syndrome (NMS). NMS causes hyperpyrexia, autonomic deregulation, and rhabdomyolysis). This can be treated with the D2 agonist “BROMOCRIPTINE”, which is used for parkinson’s. The hyperpyrexia can be treated with dantrolene, which is used for malignant hyperthermia due to inhaled anesthetics.
Uses: more + symtoms of schizophrenia

Question 2

Clozapine

Answer 2

Atypical antipsychotic
MOA: anti- D4 / 5-HT2
ADRs: more metabolic effects and fewer motor effects. Primary ADRs are agranulocytosis and HLD/WG
Uses: preferred drug for schizophrenia

Question 3

Risperidone

Answer 3

Atypical antipsychotic
MOA: anti-D2/5HT2
ADRs: still some extrapyramidal effects from D2 antagonism, but mostly weight gain and hyperlipidemia
Uses: more (-) Sx of schizophrenia

Question 4

Quetiapine

Answer 4

Atypical Antipsychotic
MOA: anti-D1/D2/5-HT2
ADRs: metabolic, and very sedating
Uses: ideal for patients with schizophrenia that suffer from insomnia due to sedation

Question 5

Aripiprazole

Answer 5

Atypical antipsychotic
MOA: anti-D2/5-HT1
Adverse effects: metabolic
Uses: schizophrenia / unipolar depression