Tuesday, September 8, 2009

Typical 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.

Typical antipsychotics (first generation antipsychotics, conventional antipsychotics, classical neuroleptics, or major tranquilizers) are older medications, developed in the 1950’s.

Types of typical antipsychotics:
• Chlorpromazine (Largactil, Thorazine)
• Fluphenazine (Prolixin)
• Haloperidol (Haldol, Serenace)
• Molindone
• Thiothixene (Navane)
• Thioridazine (Mellaril)
• Trifluoperazine (Stelazine)
• Loxapine (Loxapac, Loxitane)
• Perphenazine
• Prochlorperazine (Compazine, Buccastem, Stemetil)
• Pimozide (Orap)
• Zuclopenthixol (Clopixol)

Side effects include dry mouth, muscle soreness, tremors, and weight gain. Extrapyramidal side effects (EPS) are also common and include akathisia (restlessness), parkinsonism (tremor, hypokinesia), and dystonias (repetitive movements, abnormal posture). EPS can be treated with certain anticholinergics.

A more serious, possibly reversible, side effect is tardive dyskinesia in which involuntary, repetitive movements occur. Tardive dyskinesia usually develops with chronic antipsychotic use and may remiss upon discontinuation.

Depot injections (decanoate salts or ester forms of medications which have consistent, long-term release) of some typical antipsychotics may be used in cases where non-compliance is an issue. Common depots include haloperidol, fluphenazine, flupentixol and zuclopenthixol.

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