Antipsychotic agent

From Citizendium
Revision as of 15:05, 6 January 2009 by imported>Robert Badgett (→‎Extrapyramidal effects)
Jump to navigation Jump to search

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]

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 older drugs are called either first generation or typical antipsychotic agents. This group includes haloperidol.

Effectiveness

The second generation anti-psychotics amisulpride, clozapine, olanzapine, and risperidone may be the most effect agents for schizophrenia.[3]

Regarding the treatment of delirium, all drugs may have similar efficacy.[4]

Adverse effects

Extrapyramidal effects

The second generation agents may cause less extrapyramidal effects[3] and quetiapine may cause the least effects among this group.[2] Haloperidol less than 3 mg day reduced adverse effects.[4]

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"."[5]

References

  1. Anonymous (2024), Antipsychotic agent (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 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. 3.0 3.1 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.
  4. 4.0 4.1 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.
  5. 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]