Antipsychotic agent: Difference between revisions
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In [[medicine]], '''antipsychotic agents''' "control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in [[schizophrenia]], senile [[dementia]], transient [[psychosis]] following surgery or [[myocardial infarction]], etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus."<ref>{{MeSH}}</ref> | In [[medicine]], '''antipsychotic agents''' "control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in [[schizophrenia]], senile [[dementia]], transient [[psychosis]] following surgery or [[myocardial infarction]], etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus."<ref>{{MeSH}}</ref> | ||
Antipsychotics effect may be by blocking [[biogenic amine receptor|dopamine receptors]] (D<sub>2</sub>). | |||
==Classification== | ==Classification== | ||
The newer drugs are called either second generation or atypical antipsychotic agents. This group includes [[olanzapine]], [[quetiapine]], [[risperidone]], [[aripiprazole]], [[ziprasidone]], [[clozapine]], and [[amisulpride]].<ref name="pmid17035647">{{cite journal |author=Schneider LS, Tariot PN, Dagerman KS, ''et al'' |title=Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease |journal=N. Engl. J. Med. |volume=355 |issue=15 |pages=1525–38 |year=2006 |month=October |pmid=17035647 |doi=10.1056/NEJMoa061240 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17035647&promo=ONFLNS19 |issn=}}</ref> | The newer drugs are called either second generation or atypical antipsychotic agents. This group includes [[olanzapine]], [[quetiapine]], [[risperidone]], [[aripiprazole]], [[ziprasidone]], [[clozapine]], and [[amisulpride]].<ref name="pmid17035647">{{cite journal |author=Schneider LS, Tariot PN, Dagerman KS, ''et al'' |title=Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease |journal=N. Engl. J. Med. |volume=355 |issue=15 |pages=1525–38 |year=2006 |month=October |pmid=17035647 |doi=10.1056/NEJMoa061240 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17035647&promo=ONFLNS19 |issn=}}</ref> The atypical antipsychotics tend to also block [[biogenic amine receptor|serotonin receptors]] (5HT).<ref name="isbn0-07-145153-6chapt29">{{cite book |author=Katzung, Bertram G. |authorlink= |editor= |others= |title=Basic and Clinical Pharmacology |edition=10th |chapter= Antipsychotic Agents & Lithium |chapterurl=http://www.accessmedicine.com/content.aspx?aID=2505610 |language= |publisher=McGraw-Hill Medical Publishing Division |location=New York |year=2006 |origyear= |pages= |quote= |isbn=0-07-145153-6 |oclc= |doi= |url=http://www.accessmedicine.com/resourceTOC.aspx?resourceID=16 |accessdate=}}</ref> | ||
The older drugs are called either first generation or typical antipsychotic agents. This group includes thiozanthene derivitives such as thiothixene, and butyrophenone derivitives such as [[haloperidol]]. | The older drugs are called either first generation or typical antipsychotic agents. This group includes phenothiazine derivitives such as chlorpromazine, thiozanthene derivitives such as thiothixene, and butyrophenone derivitives such as [[haloperidol]].<ref name="isbn0-07-145153-6chapt29">{{cite book |author=Katzung, Bertram G. |authorlink= |editor= |others= |title=Basic and Clinical Pharmacology |edition=10th |chapter= Antipsychotic Agents & Lithium |chapterurl=http://www.accessmedicine.com/content.aspx?aID=2505610 |language= |publisher=McGraw-Hill Medical Publishing Division |location=New York |year=2006 |origyear= |pages= |quote= |isbn=0-07-145153-6 |oclc= |doi= |url=http://www.accessmedicine.com/resourceTOC.aspx?resourceID=16 |accessdate=}}</ref> | ||
==Effectiveness== | ==Effectiveness== | ||
Revision as of 21:00, 6 January 2009
In medicine, antipsychotic agents "control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia, senile dementia, transient psychosis following surgery or myocardial infarction, etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus."[1]
Antipsychotics effect may be by blocking dopamine receptors (D2).
Classification
The newer drugs are called either second generation or atypical antipsychotic agents. This group includes olanzapine, quetiapine, risperidone, aripiprazole, ziprasidone, clozapine, and amisulpride.[2] The atypical antipsychotics tend to also block serotonin receptors (5HT).[3]
The older drugs are called either first generation or typical antipsychotic agents. This group includes phenothiazine derivitives such as chlorpromazine, thiozanthene derivitives such as thiothixene, and butyrophenone derivitives such as haloperidol.[3]
Effectiveness
The second generation anti-psychotics amisulpride, clozapine, olanzapine, and risperidone may be the most effect agents for schizophrenia.[4]
Regarding the treatment of delirium, all drugs may have similar efficacy.[5]
Adverse effects
Extrapyramidal effects
The second generation agents may cause less extrapyramidal effects[4] and quetiapine may cause the least effects among this group.[2] Haloperidol less than 3 mg day reduced adverse effects.[5]
Cardiovascular effects
A meta-analysis concluded "all antipsychotics are associated with an increased risk of stroke, and the risk might be higher in patients receiving atypical antipsychotic"."[6]
Other effects
Withdrawing psychotropics mediations may prevent falls.[7]
References
- ↑ Anonymous (2024), Antipsychotic agent (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Schneider LS, Tariot PN, Dagerman KS, et al (October 2006). "Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease". N. Engl. J. Med. 355 (15): 1525–38. DOI:10.1056/NEJMoa061240. PMID 17035647. Research Blogging.
- ↑ 3.0 3.1 Katzung, Bertram G. (2006). “Antipsychotic Agents & Lithium”, Basic and Clinical Pharmacology, 10th. New York: McGraw-Hill Medical Publishing Division. ISBN 0-07-145153-6.
- ↑ 4.0 4.1 Leucht S, Corves C, Arbter D, Engel RR, Li C, Davis JM (January 2009). "Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis". Lancet 373 (9657): 31–41. DOI:10.1016/S0140-6736(08)61764-X. PMID 19058842. Research Blogging.
- ↑ 5.0 5.1 Lonergan E, Britton AM, Luxenberg J, Wyller T (2007). "Antipsychotics for delirium". Cochrane Database Syst Rev (2): CD005594. DOI:10.1002/14651858.CD005594.pub2. PMID 17443602. Research Blogging.
- ↑ Douglas IJ, Smeeth L (2008). "Exposure to antipsychotics and risk of stroke: self controlled case series study". BMJ 337: a1227. PMID 18755769. PMC 2526549. [e]
- ↑ Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM (1999). "Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial". J Am Geriatr Soc 47 (7): 850–3. PMID 10404930. [e]