Antipsychotics
Typical aka conventional aka first generation
Indication
Mechanism
Precautions
Adverse
Extrapyramidal side effects
Neuroleptic malignant syndrome
- Haloperidol
- Chlorpromazine
- Pericyazine
- Clozapine
- Olanzapine
- Quetiapine
- Risperidone
Indication
- relief from hallucinations, delusions in psychosis
- Sedative in agitation (aggression/anxiety)
Mechanism
- all are D2 receptor antagonists
Precautions
- Epilepsy (reduce seizure threshold)
- Respiratory depression
- hyperthyroidism
- prolonged QT
- Hypotension
- Diabetes (↑BSL)
Adverse
- dystonia
- akathesia
- Weight gain
- hyperprolactinemia: galactorrhea, amenorrhia (f), gynocomastia (m)
Extrapyramidal side effects
- Dystonia (torticollis, opisthotonus, oculogyric crisis, ..) 1-2d post commencement
- Akathesia: restlessness occurring 2-3d post (akathesia is proportional to dose, agitation inversely so i.e. titration helps differentiate)
- Parkinsonism: tremor, rigidity, bradykinesia - weeks to months
- tardive dyskinesia: involuntary movements
- hyperreflexia
Neuroleptic malignant syndrome
- fever, muscle rigidity, altered consciousness, autonomic instability