3

– the first effective antipsychotic agent
(prototype antipsychotic)

ANTIPSYCHOTIC AGENTS
● Drugs used for psychosis
● Aka Neuroleptic agents / Neuroleptics / Major Tranquilizers
● Goal of tx:

are used off-label to treat Tourette syndrome

is prescribed in some cases of Asperger's syndrome

– form of autism disorder; wherein
a child is having a hard time socializing with other people
and has very narrow interest.

• 1st Generation antipsychotics
• Blocks D1 receptor only

• 2nd Generation antipsychotics
• Blocks dopamine (D2) and serotonin (5-HT2)
o More pronounced activity at serotonin receptors

– only antipsychotics that reduces
the risk of suicidal thoughts

– causes sedation

– causes QT prolongation

– for Asperger's syndrome
• An azole but is not a proton pump inhibitor

– causes weight gain (obesity)

– for intractable hiccup

• Chlorpromazine
• Promazine
• Trifluoropromazine

• Fluphenazine,
• Perphenazine
• Acetophenazine
• Trifluorophenarine
• Prochlorperazine

• Thioridazine

● first antipsychotic developed as a surgical anesthetic

● major metabolite of thioridazine
● more potent than the parent compound and accounts for
most of the effect.

is used for Tourettes syndrome and Huntington's

● antipsychotic effects: 5-HT 2A/2C and D2 receptor
antagonism.
● more potent antagonism at the D4 receptor than the D2
receptor.
● Reduces the risk of suicidal thoughts
● Lowest likelihood in producing EPS and tardive dyskinesia

● Reserve drug for severely schizophrenic patients who are
refractory to traditional therapy.
● Most potent atypical antipsychotics

● for certain people with schizophrenia who take perphenazine
first and get no or minimal benefit and/or experience intolerable
side effects.

is not a good option for people who are overweight,
have blood sugar abnormalities, diabetes, or heart disease.

Chlorpromazine – (the most
common cardiovascular effect)

Mesoridazine –

● aka neuroleptic-induced parkinsonism
● most common (15%)

● Muscular spasm, involuntary movement
● Risk: high-potency antipsychotics
● Onset: early in tx (days)
● Tx: IM/IV anticholinergics (benztropine, diphenhydramine,
biperiden)

– tilting of neck

– locking of the jaw

Severe arching of the back

● Subjective feeling of muscular discomfort (motor restlessness)
● Agitated, pace relentlessly, alternately sit and stand
● Tx: beta-blockers (propranolol), BZDs (lorazepam), clonidine

● Most severe side effect associated w/ antipsychotics
● idiosyncratic, life-threatening
● Onset: usually within first few weeks
● Tx: discontinue meds, supportive, DANTROLENE,
bromocriptine

● Choreoathethoid Movements –
○ Uncontrollable movements
● Tongue protrusion / twisting,lip puckering
● Risk: elderly, long-term tx, female,
● Onset: years after tx