Week 10 - Antipsychotics

Question 1

What are the two classes of antipsychotics?

Answer 1

Butyropenones, phenothiazines

Question 2

What is the mechanism of action of neuroleptics?

Answer 2

Dopamine D2 receptor antagonists

-thought to be excessive dopamine release in the prefrontal cortex leading to positive symptoms of schizophrenia

Question 3

What are the adverse effects of typical antipsychotics/ neuroleptics?

Answer 3

• Parkinsonism. Tardive diskinesia
• sedation and hypotension, impaired thermoregulation and lactation
• neuroleptic malignant syndrome

-CNS depressants, anticonvulsants or antihypertensives, antacids

Contraindications - CV disease, bone marrow depression, renal, liver or thyroid dysfunction or Parkinson’s disease

Question 4

Name some atypical antipsychotics and what they treat

Answer 4

Clozapine - schizophrenia (efficacy of clozapine seems to reside in the fact that it has an even greater affinity for 5-HT receptors than for dopamine D2 receptors)

Amisulpride - schizophrenia

Risperidone - schizophrenia

Olanzepine - schizophrenia

Question 5

What are atypical antipsychotics?

Answer 5

Antagonists effective in managing psychoses and schizophrenia, treating both positive and negative symptoms of schizophrenia

Question 6

What are the side effects of atypical antipsychotics?

Answer 6

• risk of neuroleptic malignancy syndrome are low
• avoid CNS depressants, antihypertensives (risk of excessive hypotension)
• headache, blurred vision, photosensitivity, insomnia, nervousness, dizziness, GI distress
• glaucoma, peptic ulcer disease or urinary retention, dysrhythmias or hepatic dysfunction
• weight gain (rapid and excessive)

Question 7

Name some typical antipsychotics/neuroleptics

Answer 7

Chlorpromazine - psychosis, schizophrenia, behavioural problems in children

Fluphenazine - psychosis and schizophrenia

Haloperidol - psychosis and severe behavioural problems

Loxapine - mood disorders and schizophrenia