Schizoprenia

Question 1

Typical Antipsychotics

Names and MOA

Answer 1

• Chlorpromazine
• Fluphenazine
• Haloperidol
• Flupenthixol.

MOA
• Block dopamine receptors as well as acting as antagonists at other receptors (e.g. muscarinic cholinergic, histamine H1 and alpha2-adrenergic receptors).
• Lack of selectivity of action
• Chlorpromazine was the first neuroleptic drug.
• Some drugs can be given as depot slow release preparation (makes chronic SD manageable in community).

Question 2

Atypical antipsychotics

Names and MOA

Answer 2

• Risperidone
• Olanzapine (used in PBL)
• Clozapine
• Aripiprazole

MOA:
• Acts as antagonists at D2 receptors as well as antagonists 5-HT2 receptors.
• Clozapine is used in patients that are drug resistant (30% of SD patients do not respond to treatment).

Question 3

Typical Antipsychotics

Side effects

Answer 3

•	More extrapyramidal effects vs atypical (normally reversible) *
o	Tardive dyskinesia
o	Dystonia
o	Parkinsonism
o	Bradykinesia
o	Tremor
•	Weight gain
•	Postural hypotension
•	Blurred vision
•	Dry mouth (muscarinic)
•	Hypothermia
•	QT interval prolongation
•	Sudden death
•	Hyperprolactinaemia.

Question 4

Atypical Antipsychotics

Side effects

Answer 4

• Less prone to give extrapyramidal effects.
• Improve negative effects/cognitive dysfunction
• Significant weight gain
• Dyslipidaemia
• T2D (insulin resistance)
• Metabolic disturbance
• Neutropenia (clozapine)