Podcast
Questions and Answers
What major global event significantly impacted the lives of billions and the healthcare sector?
What major global event significantly impacted the lives of billions and the healthcare sector?
What was Thioridazine widely described as in the 1980s?
What was Thioridazine widely described as in the 1980s?
What remains a vital imperative during and after the pandemic despite the focus on physical health?
What remains a vital imperative during and after the pandemic despite the focus on physical health?
Which section was notably included in the latest edition of The Guidelines?
Which section was notably included in the latest edition of The Guidelines?
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Which drug is characterized as just about as 'typical' as a drug can be?
Which drug is characterized as just about as 'typical' as a drug can be?
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What commonality ties so-called atypical antipsychotics together?
What commonality ties so-called atypical antipsychotics together?
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What is a notable change in the 14th edition of The Guidelines compared to previous editions?
What is a notable change in the 14th edition of The Guidelines compared to previous editions?
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Who is recognized for contributions on the use of clozapine in the latest edition?
Who is recognized for contributions on the use of clozapine in the latest edition?
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What is the primary problem with the FGA/SGA classification?
What is the primary problem with the FGA/SGA classification?
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Which of the following drugs was synthesized in 1959?
Which of the following drugs was synthesized in 1959?
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What contribution is Emily Finch known for in the context of The Guidelines?
What contribution is Emily Finch known for in the context of The Guidelines?
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Which agent mentioned does not cause EPS but has little in common with other atypicals?
Which agent mentioned does not cause EPS but has little in common with other atypicals?
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What challenge were authors of The Guidelines likely facing during the book's writing process?
What challenge were authors of The Guidelines likely facing during the book's writing process?
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What has been conserved more due to convention than scientific basis in the guidelines?
What has been conserved more due to convention than scientific basis in the guidelines?
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Which contributor is acknowledged for their work on older adults in this edition?
Which contributor is acknowledged for their work on older adults in this edition?
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What does the distinction between first- and second-generation antipsychotics rely on?
What does the distinction between first- and second-generation antipsychotics rely on?
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What is the maximum daily dose of risperidone according to the EMA labelling?
What is the maximum daily dose of risperidone according to the EMA labelling?
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What is the maximum dose of chlorpromazine per day?
What is the maximum dose of chlorpromazine per day?
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Which of the following drugs has a maximum dose of 2400mg per day?
Which of the following drugs has a maximum dose of 2400mg per day?
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What is the maximum monthly dose for the depot form of risperidone?
What is the maximum monthly dose for the depot form of risperidone?
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Which antipsychotic has the highest maximum dose among the listed options?
Which antipsychotic has the highest maximum dose among the listed options?
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What is the maximum allowable dose of ziprasidone per day?
What is the maximum allowable dose of ziprasidone per day?
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Among the following, which drug's maximum dose is restricted to 20mg/day in its sublingual form?
Among the following, which drug's maximum dose is restricted to 20mg/day in its sublingual form?
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Which long-acting injection of aripiprazole has a maximum dose of 400mg/month?
Which long-acting injection of aripiprazole has a maximum dose of 400mg/month?
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What is the maximum dose of levomepromazine per day?
What is the maximum dose of levomepromazine per day?
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What is the maximum daily dose of iloperidone?
What is the maximum daily dose of iloperidone?
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Which type of antipsychotics are compared in the efficacy and safety for first-episode psychosis in the systematic review by Zhang JP et al.?
Which type of antipsychotics are compared in the efficacy and safety for first-episode psychosis in the systematic review by Zhang JP et al.?
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What does the meta-analysis by Leucht S et al. conclude about second-generation antipsychotic drugs for schizophrenia?
What does the meta-analysis by Leucht S et al. conclude about second-generation antipsychotic drugs for schizophrenia?
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What is the main focus of the publication by Huhn M et al. regarding antipsychotics?
What is the main focus of the publication by Huhn M et al. regarding antipsychotics?
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What does the research by Samara MT et al. investigate regarding treatment-resistant schizophrenia?
What does the research by Samara MT et al. investigate regarding treatment-resistant schizophrenia?
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According to Taylor DM, what is the current status of clozapine in treating treatment-resistant schizophrenia?
According to Taylor DM, what is the current status of clozapine in treating treatment-resistant schizophrenia?
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Which of the following studies conducted a meta-analysis of the efficacy of second-generation antipsychotics?
Which of the following studies conducted a meta-analysis of the efficacy of second-generation antipsychotics?
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What was a finding in the systematic review conducted by Leucht S et al. regarding placebo-controlled trials in acute schizophrenia?
What was a finding in the systematic review conducted by Leucht S et al. regarding placebo-controlled trials in acute schizophrenia?
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Which antipsychotic is highlighted by Siskind D et al. for its effectiveness in treatment-refractory cases?
Which antipsychotic is highlighted by Siskind D et al. for its effectiveness in treatment-refractory cases?
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What is the focus of the systematic review conducted by Leucht S et al.?
What is the focus of the systematic review conducted by Leucht S et al.?
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Which antipsychotic-related adverse effect was investigated in the study by Sorensen HJ et al.?
Which antipsychotic-related adverse effect was investigated in the study by Sorensen HJ et al.?
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What aspect of antipsychotic medication was addressed by Waddell L et al.?
What aspect of antipsychotic medication was addressed by Waddell L et al.?
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What major limitation in the treatment of schizophrenia is discussed by Falkai P?
What major limitation in the treatment of schizophrenia is discussed by Falkai P?
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Which element is compared in the review by Leucht C et al.?
Which element is compared in the review by Leucht C et al.?
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What side effect prevalence was studied by Yusufi B et al. during clozapine treatment?
What side effect prevalence was studied by Yusufi B et al. during clozapine treatment?
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What is the primary topic of the study by Pope A et al.?
What is the primary topic of the study by Pope A et al.?
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Which study addresses the risk of venous thromboembolism during antipsychotic treatment?
Which study addresses the risk of venous thromboembolism during antipsychotic treatment?
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Study Notes
Introduction
- The 14th edition of The Guidelines was published during the COVID-19 pandemic.
- The authors express gratitude to contributors for their work amidst the challenging conditions.
- Mental health issues remain a significant concern, particularly in the context of the pandemic.
- This edition incorporates new research and medications since 2017.
- It includes new sections on subjects such as agitated delirium, psychotropics at the end of life, intravenous psychotropic formulations, intramuscular clozapine and weekly oral penfluridol.
Antipsychotics Classification
- The typical/atypical dichotomy used to classify antipsychotics is not well-defined.
- Some drugs initially classified as atypical (e.g., thioridazine, sulpiride) are now considered conventional.
- Risperidone, at high doses, exhibits properties similar to typical antipsychotics.
- Atypical antipsychotics are not a homogenous group in terms of pharmacology or chemistry.
- While some atypical agents exhibit improved efficacy and lower extrapyramidal symptoms (EPS), they also have limitations.
- The introduction of newer agents like pimavanserin with antipsychotic activity and low EPS does not fit into the atypical category.
First- and Second-Generation Antipsychotics
- The FGA/SGA classification system has been adopted to address the limitations of the typical/atypical approach.
- All antipsychotics introduced since 1990 are classified as SGAs (atypical).
- The FGA/SGA classification is based on the time of introduction, which may not be a reliable indicator of pharmacological properties.
- The date of introduction can be significantly different from the date of first synthesis.
- The FGA/SGA distinction is maintained in this edition for convention despite its scientific limitations.
Licensed Maximum Doses of Antipsychotics
- The text provides a table outlining the licensed maximum doses of antipsychotics in the EU as of February 2021.
- The list includes both oral and long-acting injectable antipsychotics.
Maximum Doses of Antipsychotics Outside the EU
- A separate table details the licensed maximum doses of antipsychotics available outside the EU (FDA approved) as of February 2021.
- This list includes both oral and long-acting injectable antipsychotics.
- Note: Some drugs are available only in specific regions.
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Description
Explore the latest insights from the 14th edition of The Guidelines, focusing on antipsychotic classifications during the COVID-19 pandemic. Understand the evolving definitions of typical and atypical antipsychotics and the relevant new research that has emerged since 2017. This quiz covers key topics including new treatments and mental health challenges faced today.
