Antipsychotics

Question 1

What are some examples of Typical/1st generation antipsychotics?

Answer 1

Haloperidol, chlorpromazine, flupentixol, zuclopenthixol

Question 2

What are some examples of Atypical/2nd generation antipsychotics?

Answer 2

Risperidone, olanzapine, quetiapine, clozapine, aripiprazole, paliperidone

Question 3

What is the difference between typical and atypical antipsychotics?

Answer 3

Atypical have a greater serotonergic effect and fewer extrapyramidal side effects, however they also have more metabolic side effects.

Question 4

What are the general side effects associated with antipsychotics?

Answer 4

1. Extrapyramidal - dystonia, Parkinsonism, akathisia, dyskinesia
2. Antimuscarinic
3. Metabolic - central obesity, high BP, high triglycerides, low HDL, insulin resistance
4. Increased QTc on ECG

Question 5

What is the action of clozapine?

Answer 5

2nd generation antipsychotic, acts on dopamine an serotonin

Question 6

Why is it reserved for treatment-resistant psychosis (already received two other treatments)?

Answer 6

Because it is highly effective (up to 60% benefit) but the side effects can be very dangerous and require close monitoring

Question 7

What are the side effects of clozapine?

Answer 7

Weight gain, hypersalivation, decreased GI motility, neutropenia, myocarditis