Antipsychotic drugs antipsychotics typical

OzbQen M, Adams CE, Marley J. Anticholinergic effects of oral antipsychotic drugs of typicals versus atypicals over medium- and long-term systematic review and meta-analysis. Ciur Med Chem 2012 19(30) 5214-8. 

Typical antipsychotic drugs Neuroleptic dtugs conventional antipsychotic diugs older antipsychotic diugs ... 

Clozapine versus typical antipsychotic drugs uncontrolled mirror-image studies. 

Clozapine randomized, controlled trials versus typical antipsychotic drugs. 

Lee, C. et al. (2006). Treatment with olanzapine, risperidone or typical antipsychotic drugs in Asian patients with schizophrenia. Aust. N. Z. J. Psychiatry, 40, 437-45. 

Kaiser etal. (2000) DRD4 (48-bp repeat) Typical antipsychotic drugs, clozapine No association. Schizophrenia Caucasian... 

Joober etal. (1999) HTR2A (T102C) Typical antipsychotic drugs Trend toward association between C/C genotype and poor response among Schizophrenia Caucasian... 

Of the antipsychotic drugs prescribed, 72% were typical antipsychotics, which included haloperidol, chlorpromazine, levomepromazine, sulpiride, trifluoperazine, fluphenazine, flupentixol, and bromperidol. Use of typical drugs was associated with longer hospitalization, male gender, and clinical reports of violence or aggression. Atypical drugs only accounted for 28% of antipsychotic drugs... 

Akathisia The motor restlessness often noted as a side effect of long-term administration of typical antipsychotic drugs. 

Butyrophenones A family of typical antipsychotic drugs (neuroleptics), the most commonly used being haloperidol. 

Clozapine is the prototype of atypical antipsychotic drugs, and it has been used effectively to treat patients with schizophrenia who are unresponsive or intolerant to typical antipsychotics [7]. Clozapine is characterized as atypical by its preferential binding to serotonin (5-HT2) and dopamine D4 receptors (D4) relative to dopamine D2 receptors [8]. A recent body of work also suggests that atypicality may be defined by the rate at which clozapine dissociates from D2 receptors. Specifically, clo-... 

Stockmeier CA, DiCarlo JJ, Zhang Y, Thompson P, Meltzer HY. Characterization of typical and atypical antipsychotic drugs based on in vivo occupancy of sero-tonin2 and dopamine2 receptors. J Pharmacol Exp Ther 1993 266(3) 1374-1384. 

Kroeze, W. K., Hufeisen, S. J., Popadak, B. A. et al. HI-histamine receptor affinity predicts short-term weight gain for typical and atypical antipsychotic drugs. Neuropsychopharmacology 28 519-526, 2003. 

The positive symptoms are the most responsive to antipsychotic medications, such as chlorpromazine or halo-peridol. Initially, these drugs were thought to be specific for schizophrenia. However, psychosis is not unique to schizophrenia, and frequently occurs in bipolar disorder and in severe major depressive disorder in which paranoid delusions and auditory hallucinations are not uncommon (see Ch. 55). Furthermore, in spite of early hopes based on the efficacy of antipsychotic drugs in treating the positive symptoms, few patients are restored to their previous level of function with the typical antipsychotic medications [2]. 

The typical antipsychotic drugs, which for 50 years have been the mainstay of treatment of schizophrenia, as well as of psychosis that occurs secondary to bipolar disorder and major depressive disorder, affect primarily the positive symptoms[10]. The behavioral symptoms, such as agitation or profound withdrawal, that accompany psychosis, respond to the antipsychotic drugs within a period of hours to days after the initiation of treatment. The cognitive aspects of psychosis, such as the delusions and hallucinations, however, tend to resolve more slowly. In fact, for many patients the hallucinations and delusions may persist but lose their emotional salience and intrusiveness. The positive symptoms tend to wax and wane over time, are exacerbated by stress, and generally become less prominent as the patient becomes older. 

Atypical antipsychotics may be helpful in managing the delusions and agitated behavior that can accompany dementia. These medications, include risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify), and olanzapine (Zyprexa). All antipsychotics, typical and atypical, appear to increase the risk of death in patients with dementia and psychosis. This appears as a warning in the package inserts of the newer drugs. A prudent approach is to discuss this risk with the caregiver, use the lowest effective dose, and monitor for effectiveness. 

Schizoid Personaiity Disorder (SPD). Again, there is very little research to guide in the selection of medications to treat the schizoid patient. If we conceptualize the symptoms of SPD as most resembling the negative symptoms of schizophrenia, the choice of agents would tend to favor the atypical antipsychotic drugs as opposed to the older typical antipsychotics. Consequently, we also recommend low doses of an atypical antipsychotic as a first-line treatment for SPD. 

Dopaminergic projections from the hypothalamus to the pituitary gland tonically inhibit the production and release of prolactin via D2 receptors. The blockade of these receptors leads to hyperprolactinemia, a common side effect of compounds such as typical antipsychotic drugs. 

Antipsychotic drugs with strong sedative clinical effects (e.g. chlorpromazine. clozapine, olanzapine) produce subjective and objective sedation and impair most areas of performance in healthy volunteers, usually at doses far below those typically used in patients. Antipsychotic drugs with little sedative clinical action (e.g. pimozide, sulpiride, amisulpride) produce few subjective and objective effects in healthy... 

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