Antipsychotics Flashcards
Which antipsychotic is most likely to cause retinal deposits?
Chlorpromazine
Which antipsychotic reduces prolactinemia?
Aripiprazole
Which antipsychotics are most likely to cause weight gain?
Olanzapine, clozapine, chlopromazine.
Quetiapine and respiradone are also likely.
Which antipsychotic is safest in Parkinson’s psychosis?
Quetiapine
Which SGA is post likely to cause postural hypotension?
Clozapine and chlorpromazine.
Also risperidone and quetiapine
Which antipsychotics are most likely to cause sedation?
Olanzapine, quetiapine, clozapine, chlorpromazine
Which examinations and investigations need to be performed prior to commencing antipsychotics, as well as yearly?
BMI, waist circumference Fasting BGL, HbA1c Fasting lipids FBE Prolactin Beta-HCG ECG EEG (annual test not required) Ophthalmological evaluation
Following antipsychotic commencement, what needs to be regularly monitored?
Weight, BMI - every 4 weeks
Waist circumference, fasting BGL, HbA1c, fasting lipids - every 12 weeks
FBE, prolactin, ECG - every 24 weeks
Which is the only antipsychotic that can reduce suicidal behaviour in schizophrenia?
Clozapine
What are the indications for clozapine?
Treatment-resistant schizophrenia
Tardive dyskinesia
What is treatment resistant schizophrenia?
Continued positive symptoms after trials of at least two different antipsychotics (from two different classes) at moderate doses for a reasonable period (usually at least 6 weeks).
What are the contraindications for clozapine?
Severe cardiac disease, clozapine-induced myocarditis
Bone marrow disorders, drug-induced neutropenia or agranulocytosis
Severe renal or hepatic impairment
Try avoid in breastfeeding
CNS depression, EtOH or toxic psychosis, poorly controlled epilepsy
Paralytic ileus
What are the adverse effects specific to clozapine?
Agranulocytosis
Myocarditis
Rebound psychosis if ceased
Drooling, constipation, stroke, VTE
What are the additional baseline investigations required before commencing clozapine?
Troponin, CPK-MB
Echocardiogram
What are the four major EPSE effects?
Dystonia
Akathisia
Parkinsonism
Tardive dyskinesia
