Antipsychotic drugs antipsychotics behavioral effects

Geriatric Considerations - Summary Sink and colleagues systematic review showed statistically significant improvements on neuropsychiatric and behavioral scales for some drugs, but improvements were small and unlikely to be clinically important. Because of documented risks, and uncertain benefits, antipsychotic drugs should be used with caution in demented elderly persons, with frequent monitoring for side effects and a low threshold for discontinuing use. 

FIG. 5-3. Effects of neuroleptics on thought disorder and behavioral symptoms of schizophrenia. BPRS, Brief Psychiatric Rating Scale TDI, Thought Disorder Index. (From Davis JM, Barter JT, Kane JM. Antipsychotic drugs. In Kaplan HI, Sadock BJ, eds. Comprehensive textbook of psychiatry, 5th ed. Baltimore Williams Wilkins, 1989 1604, with permission.)... 

Migler BM, Warawa EJ, Malik JB. Seroquel behavioral effects in conventional and novel tests for atypical antipsychotic drug. Psychopharmacology 1993 112 299-307. 

Ungerstedt, V., Ljungberg, T. (1977). Behavioral patterns related to dopamine neurotransmission Effect of acute and chronic antipsychotic drugs. Advances in Biochemical Psychopharmacology, 16, 193-199. 

Clonazepam is a benzodiazepine that is used predominantly in epilepsy, panic disorder, and mania, and also appears to be effective in relieving antipsychotic drug-induced akathisia (1). The use of clonazepam in psychiatric disorders is complicated by significant drowsiness in a majority of patients, and additional behavioral problems in children (SEDA-19, 34). 

The basic—but oversimplified—notion regarding antipsychotic medications is that they primarily affect the reticular activating system, the limbic system, and the hypothalamus. The effects on the reticular activating system generally moderate spontaneous activity and decrease the patient s reactivity to stimuli. The action within the limbic system serves to moderate or blunt emotional arousal. These actions arc thought to produce the drug s dramatic effects on schizophrenic or agitated behavioral patterns. The effects on the hypothalamus help modulate metabolism, alertness, and muscle tone. Because of these effects, antipsychotics arc the major approach to... 

In the final chapter, an expert pharmacologist. Dr. Terrell Gibbs presents a comprehensive review of pharmacotherapies in autism. He details their results from clinical trials, their effectiveness, and their role in the treatment of autistic behaviors. Special emphasis is given to the atypical antipsychotic drug risperidone that is frequently effective for ameliorating symptoms of irritability, hyperactivity, social withdrawal, and stereotypic, repetitive behavior in autism. 

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