Thursday, September 3, 2009

Atypical Antipsychotics

As per the name, antipsychotics are used to treat psychosis, most commonly in schizophrenia though other disorders may also feature psychotic symptoms. Due to their sedative and tranquilising effects, antipsychotics may also be used as a mood stabiliser, anxiolytic, or sleep aid. The two types of antipsychotic are typical and atypical.

Atypical (second generation) antipsychotics are the newer variety.

Types of atypical antipsychotics:

• Amisulpride (Solian)
• Aripiprazole (Abilify)
• Asenapine (Saphris)
• Clozapine (Clozaril, Leponex, Fazaclo, Froidir, Denzapine, Zaponex, Klozapol, Clopine)
• Iloperidone (Fanapt, Fanapta, Zomaril)
• Melperone (Buronil, Burnil, Eunerpan)
• Olanzapine (Zyprexa, Zyprexa Zydis, Zalasta, Zolafren, Olzapin, Rexapin, Symbyax)
• Paliperidone (Invega)
• Perospirone (Lullan)
• Quetiapine (Seroquel, Ketipinor)
• Risperidone (Risperdal, Ridal, Sizodon, Riscalin, Rispolept, Belivon, Rispen)
• Sertindole (Serdolect, Serlect)
• Sulpiride (Meresa, Sulpirid, Bosnyl, Dogmatil, Eglonyl, Sulpiryd)
• Ziprasidone (Geodon, Zeldox)

Atypicals are a common first line of treatment because of the reported decrease of extrapyramidal side effects (EPS), which though still occurs, appears to be attenuated. Research is still being conducted on the long-term effects of atypicals and tardive dyskinesia (a common and serious side effect with typical antipsychotics).

Other side effects include weight gain, diabetes mellitus, hyperlipidemia, myocarditis, sexual dysfunction, cataract, somnolence, and syncope.

Elderly patients with dementia should not receive either olanzapine or risperidone because of an increased risk of stroke.

Atypicals have yet to be approved for use in paediatric patients. In the news recently was discussion of prescriptions of quetiapine for children. The case was argued that physicians shouldn’t be prescribing medications, and ones with serious side-effects at that, without having more knowledge about the subject. An argument I agree with, and yet research involving children is difficult to accomplish due to reservations and ethics.

References: 1

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