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Antipsychotic

Medication: Atypicals

Reinburg, S (2012). Antipsychotic drugs boost stroke risk. September 25, 2012.
http://abcnews.go.com/Health/Healthday/story?id=5681581&page=1#.UGXYlU-qXCc

Sheryl Sato
NURS 110
September 29, 2012

Introduction
An antipsychotic (or neuroleptic) is a

tranquilizing psychiatric medication


primarily used to manage psychosis.
First generation of antipsychotics:

typical antipsychotics.
Second generation of

antipsychotics: atypical
antipsychotics.
Both generations of medication tend

to block receptors in the brains


dopamine pathways.

Atypical
Antipsychotics

The following are approved and marketed in

various parts of the world:


Amisulpride (Solian)
Asenapine (Saphris)
Blonanserin (Lonasen)
Carpipramine (Prazinil)

Mosapramine (Cremin)
Olanzapine (Zyprexa)
Paliperidone (Invega)

Clocapramine (Clofekton)

Perospirone (Lullan)

Clotiapine (Entumine)

Quetiapine (Seroquel)

Clozapine (Clozaril)

Remoxipride (Roxiam)

Iloperidone (Fanapt)

Risperidone (Risperdal)

Lurasidone (Latuda)
Pimavanserin (ACP-103)
Vabicaserin (SCA-136)

Sertindole (Serdolect)
Sulpiride (Sulprid, Eglonyl)
Ziprasidone (Geodon, Zeldox)
Zotepine (Nipolept)

Therapeutic Uses
Common Conditions:
Schizophrenia
Bipolar disorder
Delusional disorder

May also be used to counter psychosis


associated with other diagnoses, such as
psychotic depression.
However, not all symptoms require heavy
medication and hallucinations and
delusions should only be treated if they
distress the patient or produce dangerous
behaviors. (Powers, 2008)

Therapeutic Uses
Antipsychotics have also been increasingly used off-

label in older people with dementia & children/


teenagers with disorders.
A survey of children with pervasive developmental

disorder found that 16.5% were taking an


antipsychotic drug, most commonly to alleviate mood
and behavioral disturbances characterized by
irritability, aggression, and agitation. Recently,
risperidone was approved by the US FDA for the
treatment of irritability in children and adolescents
with autism. (Posey, 2008)
Antipsychotics are sometimes used as part of

compulsory treatment via inpatient commitment or


outpatient commitment.

Dosages
Administration
Injectable form: (depot injection), usually

applied to the butt every 2-4 weeks.

while those available as depot (as well as


pills) are haloperidol, fluphenazine and other
phenothiazines, thioxanthenes such as
flupenthixol and clopenthixol, and the atypical
risperidone.

Pill form

clozapine, olanzapine, and ziprasidone, and


other recently discovered atypicals

Dosages

Adverse
Side
Effects

Lowered life expectancy

extrapyramidal effects on motor control


decrease in brain volume
enlarged breasts in men & milk discharge

in women
lowered white blood cell count,
involuntary repetitive body movements
diabetes
sexual dysfunction
a return of psychosis requiring higher

medication dosages.

Advantage over
Typical Antipsychotics
In contrast, other researchers point to the significantly
higher risk of tardive dyskinesia and EPS with the
typicals and for this reason alone recommend first-line
treatment with the atypicals, notwithstanding a greater
propensity for metabolic adverse effects in the latter.
(Meltzer, 2006)

References
Reinberg, Steven. (2012). Antipsychotic drugs boost

stroke risk. Retrieved September 22, 2012.


http://abcnews.go.com/Health/Healthday/story?id=
5681581&page=1#.UGXYlUqXCc
Howland, Robert H. (2008). Risks and benefits of

antipsychotic drugs in elderly patients with dementia.


Journal of Psychosocial Nursing & Mental Health
Services, 19-23.
Howland, Robert H. (2010). Potential adverse effects

of discontinuing psychotropic drugs. Journal of


Psychosocial Nursing & Mental Health Services, 11-13.
Powers, S. (2002). Atypical antipsychotics:

mechanism of action. Canadian Journal of Psychiatry,


47 (1), 27. Retrieved from Psychology Behavioral
Sciences Collection database.

References
Reinburg, S (2012). Antipsychotic drugs

boost stroke risk. September 25, 2012.


http://abcnews.go.com/Health/Healthday/s
tory?id=5681581&page=1#.UGXYlU-qXCc