1. In Class Activity: Antipsychotic Table
AtypicalAntipsychotic Typical Antipsychotic
Action Block postsynaptic dopamine receptors in
the basal ganglia, hypothalamus, limbic
system, brainstem and medulla. These
medications also affect serotonin levels.
Blocks post-synaptic Dopamine-2 (D2) receptors in the basal
ganglia, hypothalamus, limbic system, brainstem, and
medulla.
Intended Effects  Treatment of hallucinations and
delusions (psychotic symptoms). They
may also be seen in bipolar disorder,
major depression, and delusional
disorder.
 Treatment of the negative symptoms of
schizophrenia, e.g. flat affect, apathy,
lack of motivation, social withdrawal.
 Reduction in aggressive behavior.
 Augmentation of antidepressant and
antimanic medications.
 Treatment of hallucinations and delusions (psychotic
symptoms). They may also be seen in bipolar disorder, major
depression, and delusional disorder.
 Treatment of tics, vomiting, and intractable hiccups.
 Reduction in aggressive behavior
** These drugs are not very helpful with negative symptoms.
Common Side Effects
to both the typical and
Atypical
Side or Adverse Effects
 Extrapyramidal side effects (EPS) see
description below ** much less than the
Typical
 Sedation
 Anticholinergic effects see description
below
** much less than the Typical
Side or Adverse Effects
 Extrapyramidal side effects (EPS) see description below
 Sedation
 Anticholinergic effects see description below
 Weight gain
 Photosensitivity
 Decreased Seizure threshold
 Orthostatic hypotension

2.  Weight gain
 Photosensitivity
 Decreased Seizure threshold
 Orthostatic hypotension
 Galactorrhea/amenorrhea
 Sexual dysfunction
 Galactorrhea/amenorrhea
 Sexual dysfunction
Contraindications  CNS depressants like alcohol have
additive depressant effects when given
with these drugs.
 Cigarette smoking causes reduced
plasma concentrations of some
antipsychotics
 Beta-blockers given with antipsychotics
can cause severe hypotension
 Anti-depressants in conjunction with
antipsychotics may cause increased
blood concentration of the antidepressant
 SSRI’s in conjunction with antipsychotics
may cause sudden onset of
extrapyramidal symptoms (EPS).
 CNS depressants like alcohol have additive depressant
effects when given with these drugs.
 Cigarette smoking causes reduced plasma concentrations of
some antipsychotics
 Beta-blockers given with antipsychotics can cause severe
hypotension
 Anti-depressants in conjunction with antipsychotics may
cause increased blood concentration of the antidepressant
 SSRI’s in conjunction with antipsychotics may cause sudden
onset of extrapyramidal symptoms (EPS).
Toxic effect Neuroleptic Malignant Syndrome (NMS)
see description below
Neuroleptic Malignant Syndrome (NMS) see description below
Teaching  Regular administration of antipsychotic
medications can prevent exacerbations
of psychosis.
 Those taking clozapine must have their
blood counts monitored frequently
because the drug may cause bone
marrow toxicity
 Risperdal is available in a depot
preparation, and may be more effective
in this form, especially in those having
 Taking these drugs regularly will prevent recurrence of
psychotic and other symptoms. Failure to take anti-
psychotics as prescribed can lead to relapses and repeated
hospitalizations.
 Doses should be lowered for the elderly
 Haldol and Prolixin are available in depot preparations, and
may be more effective in this form, especially in those having
problems adhering to their oral regimens.

3. problems adhering to their oral regimens.
Drugs  Clozaril (clozapine)
 Risperdal (risperidone)
 Zyprexa (olanzepine)
 Seroquel (quetiapine)
 Geodon (ziprasidone)
 Abilify (aripiprazole)
 Invega (paliperidone)
 Haldol (haloperidol)
 Prolixin (fluphenazine)
 Trilafon (perphenazine)
 Stelazine (trifluoperazine)
 Navane (thiothixene)
 Thorazine (Chlorpromazine)