Antipsychotic drugs advantages

Atypical antipsychotics have advantages in tolerabihty and safety over the older drugs. They have a lower incidence of extrapyramidal movement disorders, but may cause sedation and weight gain. Their metabolism by CYP450 enzymes leads to a potential for interaction with many co-prescribed drugs. 

The authors suggested that olanzapine may offer advantages for selected patients in whom hyperprolactinemia occurs during treatment with other antipsychotic drugs. 

Pnor to 1975, discussions of fluonnatcd pharmaceuticals focused mainly on anti-mflammatory steroids, antipsychotic phenothiazines, and 5-fluorouraciI and Its derivatives as anticancer agents [/ 2] Dunng the past 25 years, and especially in the last decade, tluonnated dmgs have been marketed for the treatment of a wide variety of diseases This section will focus on those presently marketed drugs where the presence of fluonne has produced significant therapeuhc advantages... 

Further chemical modification of the phenylpiperidine moiety has proven unusually fruitful in producing medicinal agents that affect the central nervous system. First, a series of compounds loosely related to the reversed meperidines produced several drugs with important antipsychotic activity. Further discussion of this pharmacologic activity, often referred to as major tranquilizer activity, will be found in the section on phenothiazines. The group led by Janssen took advantage of the chemistry of the... 

FIGURE 11—60. When all else fails, if all of the atypical antipsychotics show insufficient efficacy, it may be necessary to use high doses. This is quite costly and leads to loss of the atypical therapeutic advantages of such drugs. Another option is to give a second antipsychotic from the conventional class to augment an inadequately efficacious atypical antipsychotic. 

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