Atypical Antipsychotics PDF

Antipsychotic Drugs (Neuroleptics) I. Second Generation Antipsychotics (Atypical) Second-generation (novel or atypical) antipsychotics, with the exception of aripiprazole, are dopamine D2 antagonists, but are associated with lower rates of extrapyramid...

Antipsychotic Drugs (Neuroleptics) I. Second Generation Antipsychotics (Atypical) Second-generation (novel or atypical) antipsychotics, with the exception of aripiprazole, are dopamine D2 antagonists, but are associated with lower rates of extrapyramidal adverse effects and TD than the first-generation antipsychotics. However, they have higher rates of metabolic adverse effects and weight gain 1. Clozapine I.kinetics: II.Dynamics: Mechanism of Action  Weak D2-receptor  anticholinergic, antihistaminic effects are significant  antiserotoninergic (5-HT1C, 5-HT2, 5-HT3) properties. III.uses: - Refractory schizophrenia, especially in atypical type with negative manifestations. Why? - Reducing the risk of recurrent suicidal behavior in schizophrenia or schizoaffective disorder. IV. Adverse Effects: System Neurological Cardiovascular Hematological GIT Metabolic Adverse Sedation Tachycardia Agranulocytosis Constipation Weight Effect gain Drooling Cardiomyopathy Frequent CBC myocarditis Dizziness 2. Rispirdone I. kinetics: II. Dynamics] III. Mechanism of Action: Has high affinity for serotonin type 2 (5-HT2) receptors; binds to dopamine D2 receptors antagonizes alpha1-adrenergic, alpha2-adrenergic, and histaminergic receptors;. Improves negative symptoms of psychoses and reduces incidence of EPS. IV. Adverse effects : Mild sedation, hypotension, akathisia, increase in prolactin, and weight gain  3. Other Atypical anti-psychotic drugs: drug comment Asenapine Mechanism of action: Acts as an antagonist at dopamine D2 and serotonin 5-HT2 receptors. The addition of serotonin antagonism to dopamine antagonism may improve the negative symptoms of psychoses and may reduce the incidence of extrapyramidal adverse effects when compared with typical antipsychotics. Asenapine is indicated for acute and maintenance treatment of schizophrenia. side effects :sedation, weight gain, dizziness and extrapyramidal symptoms Olanzapine Mechanism of Action Acts through combination of dopamine and serotonin type 2 receptor site antagonism Side effects of olanzapine include weight gain, sedation, akathisia, hypotension, dry mouth and constipation. Serotonin- Serotonin-dopamine activity modulators (SDAMs) act as a partial Dopamine agonist at 5-HT1A and dopamine D2 receptors at similar potency, Activity and as an antagonist at 5-HT2A and noradrenaline alpha1/2 Modulators receptors Aripiprazole A partial agonist at dopamine D2 and serotonin 5-HT1A receptors and an antagonist at serotonin 5-HT2A receptors, alpha1, and histamine H1 receptors. Uses: acute and maintenance treatment of schizophrenia &for acute and maintenance treatment of bipolar I disorder, adjunctive therapy for major depressive disorder adverse effects: headache, nausea, vomiting, insomnia, tremor, and constipation