Second generation antipsychotics

Compared to the older antipsychotics (first-generation antipsychotics), the more recently developed second-generation antipsychotics are associated with a lower risk of motor side effects (tremor, stiffness, restlessness, and dyskinesia) may offer greater benefits for affective, negative, and cognitive symptoms and may prolong the time to psychotic relapse. 

Second-generation antipsychotics as a class are heterogeneous with regard to side-effect profiles. Many second-generation antipsychotics carry an increased risk for weight gain and for... 

Second-Generation Antipsychotic Usual Target Dose (mg/day) Maximal Dose Likely to Be Beneficial (mg/day) Available Dosage Forms... 

TABLE 34-4. Comparative Side Effects among the Second-Generation Antipsychotics and Haloperidol... 

TABLE 34-10. Monitoring Protocol for Patients on Second-Generation (Atypical) Antipsychotics... 

It is clear that ethnic differences in response to antipsychotics exist (Emsley et al, 2002 Frackiewicz et al, 1997). Whereas there has been some work examining first-generation antipsychotics (FGAs) (for reviews, see Frackiewicz etal, 1997 Poolsup et al, 2000), there remains a considerable dearth of research that has examined ethnic differences with respect to the second-generation antipsychotics (SGAs). 

Table 4.2 Principal enzymes involved in metabolism of second-generation antipsychotics...

SGAs = second-generation antipsychotics (SGAs) FM03 = flavin-containing monooxygenase TCAs = tricyclic antidepressants Adapted from de Leon et al., 2005b... 

Racial discrepancies in the use of second-generation antipsychotics (SCAs)... 

Apart from conducting the survey before the availability of second-generation antipsychotics (SGAs), other limitations of this study included the requirement of... 

Waddington J and Casey D (2000). Comparative pharmacology of classical and novel (second-generation) antipsychotics. In PF Buckley and JL Waddington (eds), Schizophrenia and Mood Disorders (pp. 1-13). Butterworth-Heinemann, Oxford, UK. 

Current antipsychotics used to treat patients are divided into two classes the first generation antipsychotics (FGA) or typicals (e.g., chlorproma-zine, haloperidol, thioridazine, and loxapine) and the second generation antipsychotics (SGA) or atypicals (i.e., clozapine, olanzapine, quetiapine, risperidone, aripiprazole, ziprasidone, and asenapine). 

Perphenazine 20-25 8.1-123 Second-generation antipsychotics (SGAs) CYP2D6 7-OH-perphenazine... 

Atypical antipsychotics The second generation or so-called atypical antipsychotics have chemical, pharmacological, and clinical properties that are different from those of the classical antipsychotics/ neuroleptics. The most commonly used atypicals include clozapine, olanzapine, risperidone, and quetiapine. 

The first of the second-generation, or atypical, antipsychotics was clozapine. Clozapine (Clozaril) is relatively free of the movement disorders that characterize the first-generation drugs. This is true of, and defines, second-generation, atypical antipsychotics. It was a significant breakthrough for schizophrenia patients. 

Correll CU, Leucht S, Kane JM. Lower risk for tardive dyskinesia associated with second-generation antipsychotics a systematic review of 1-year studies. Am J Psychiatry 2004 161 414-425. 

Duggan, Mark. 2005. Do New Prescription Drugs Pay for Themselves The Case of Second-Generation Antipsychotics. Journal of Health Economics 2A l-31. 

The conventional antipsychotics have little effect on the negative psychotic symptoms such as autism, stupor and emotional withdrawal. The so-called atypical antipsychotics, or second-generation antipsychotics, like the heterocyclic compound risperidone, the benzamide sulpiride and several diben-zepines of which clozapine is the best known, have a broader spectrum which means that they also have an effect on the negative psychotic symptoms. Most share a common attribute of working on serotonin receptors as well as dopamine receptors. They have a low risk of extrapyramidal side effects. 

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