Atypical Antipsychotics

Question 1

Mechanism of action of atypical antipsychotics

Answer 1

D2 receptor antagonism

5HT2A receptor antagonism

Question 2

Why do atypicals have less side effects than typicals (EPS, tardive dyskinesia, NMS)

Answer 2

Serotonin normally inhibits dopamine transmission in the tracks besides mesolimbic
Serotonin blockage therefore increases dopamine in the mesocortical, tuberoinfundibular, and nigrostriatal tracts reducing negative symptoms, prolactin and EPS

Question 3

Which atypical does NOT have less side effects than typicals

Answer 3

Risperidone

Question 4

What side effect is prevalent throughout atypicals?

Answer 4

Weight gain! (metabolic syndrome)

Can start metformin on the side

Question 5

Which atypicals are the worst for weight gain?

Answer 5

Clozapine (Clozaril) > Zyprexa (Olanzapine) > Quetiapine (Seroquel)

Question 6

Which atypical is the most weight neutral?

Answer 6

Aripiprazole (Abilify)

Question 7

What medications are atypicals?

Answer 7

Clozapine (Clozaril)
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Ziprasidone (Geodon)
Aripiprazole (Abilify)
Paliperidone (Invega)
Iloperidone (Fanapt)
Asenapine (Saphris)
Lurasidone (Latuda)