Atypical (2nd generation) antipsychotics

Question 1

Examples of atypical (2nd gen) antipsychotics?

Answer 1

Olanzapine, risperidone, lurasidone and clozapine

Question 2

Why are the effects of 2nd gen antipsychotics less severe than 1st gen?

Answer 2

This is because there is a decreased risk of extrapyramidal side effects as compared to first-generation antipsychotics.

Which makes them more favoured amongst patients.

Question 3

Adverse effects of 2nd gen antipsychotics are metabolic as opposed to 1st gen which are neurological. true/false?

Answer 3

True

Question 4

2nd gen antipsychotics do not contribute to type 2 diabetes mellitus risk. true/false?

Answer 4

False

2nd gen antipsychotics have adverse metabolic effects. Increasing risk of T2DM, hypercholesterolaemia etc.

Question 5

Pharmacological differences between 1st gen and 2nd gen antipsychotics?

Answer 5

1st gen = D2 antagonists - works on the different dopamine pathways i.e. mesolimbic, mesocortical, nigrostratial and tuberoinfundibular pathways.

2nd gen = D2/5HTa antagonists - also blocks D2 receptors but also blocks 5HTa (serotonin) receptors resulting in sedation and fatigue.

Question 6

What is another use of antipsychotics apart from schizophrenia?

Answer 6

Management of bipolar affective disorder. Used as a mood stabiliser

Question 7

What is an atypical (2nd gen) antipsychotic used for treatment resistant schizophrenia?

Answer 7

Clozapine

This antipsychotic can be used in cases of treatment resistant schizophrenia where the patient has not responded to 2 previous consecutive trials of antipsychotics