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Medication: Atypicals

Reinburg, S (2012). Antipsychotic drugs boost stroke risk. September 25, 2012.

Sheryl Sato
NURS 110
September 29, 2012

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
Both generations of medication tend

to block receptors in the brains

dopamine pathways.


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:
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.

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

Pill form

clozapine, olanzapine, and ziprasidone, and

other recently discovered atypicals



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
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)

Reinberg, Steven. (2012). Antipsychotic drugs boost

stroke risk. Retrieved September 22, 2012.
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.

Reinburg, S (2012). Antipsychotic drugs

boost stroke risk. September 25, 2012.