Thioridazine risperidone

Cyt 2D6 metabolizes haloperidol, risperidone, thioridazine, sertindole, olanzapine and clozapine common substrates - fluoxetine, paroxetine, sertraline, venlafaxine, amitriptyline, clomipramine, desipramine, imipramine, nortriptyline, propranolol, metoprolol, timolol, codeine, encainide, flecanide. Common inhibitors - paroxetine, sertraline, fluoxetine. 

IMATINIB 1. ANTIARRHYTHMICS -flecainide, mexiletine, propafenone 2. ANTIDEPRESSANTS - fluoxetine, paroxetine, TCAs, trazodone, venlafaxine 3. ANTIPSYCHOTICS -clozapine, haloperidol, perphenazine, risperidone, thioridazine 4. BETA-BLOCKERS - metoprolol, propanolol, timolol 5. DONEPEZIL 6. METHAMPHETAMINE Imatinib may cause t plasma concentrations of these drugs, with a risk of toxic effects Inhibition of CYP2D6-mediated metabolism of these drugs Watch for early features of toxicity of these drugs... 

Timolol Desip ra mine Fluoxetine Fluvoxamine Imipramine Mianserin Nortriptyline Paroxetine Risperidone Thioridazine Zuclopenthixol Perhexiline Propafenone Sparteine Dextromethorphan Phenformin Tramadol... 

Amitriptyline -Clomipramine Desipramine Imipramine Paroxetine Antipsychotics Haloperidol Risperidone Thioridazine Codeine... 

Chlorpromazine, clomipramine, perphenazine, phenoxybenzamine, risperidone, thioridazine... 

Quetiapine does not appear to interact with haloperidol or risperidone. Thioridazine moderately reduces quetiapine levels and a case report describes a seizure in a patient taking olanzapine and quetiapine. 

Neuroleptic malignant syndrome is characterised by hyperthermia, severe muscle rigidity, autonomic dysfunction and altered mental state. A study of 24 patients who had received a variety of antipsychotics (chlorpromazine, zotepine, paliperidone, bromperidol, supliride, risperidone, thioridazine, olanzapine, fluphenazine, haloperidol, levoproma-zine) demonstrated a temporal relationship of muscle rigidity and elevated creatine kinase to fever [46 ]. 

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). 

If a change in antipsychotic therapy is required, risperidone, molindone, thioridazine, haloperidol, pimozide, trifluoperazine, and fluphenazine may be considered. 

Risperidone and olanzapine have been widely used in patients with dementia exhibiting behavioural problems. Following the withdrawal of thioridazine from the market, old age psychiatrists and GPs were increasingly atypical antipsychotics, in particular risperidone as it was the only atypical which had been examined in randomised clinical trials (RCTs) with the elderly. In 2004, the advised that both risperidone... 

Inhibitors codeine, encainide, flecainide, fluoxetine, haloperidol, hydrocodone, 4-methoxy-amphetamine, metoprolol, mexiletine, oxycodone, paroxetine, propafenone, propoxyphene, risperidone, selegiline (deprenyl), thioridazine, most tricyclic antidepressants, timolol Fluoxetine, haloperidol, paroxetine, quinidine... 

Chlorpromazine, thioridazine, perphenazine, haloperidol, reduced haloperidol, risperidone, clozapine, sertindole Others... 

There are two classes of a-adrenergic receptors, aj and a2. Agents with the greatest affinity for aj blockade are chlorpromazine, thioridazine, and risperidone. There are no known beneficial effects associated with a -adrenergic receptor antagonism. However, aj-adrenergic receptor blockade can lead to hypotension, dizziness, and reflex tachycardia (Table 26.2). a2 Blockade is modest for most agents except for risperidone and clozapine. As with aj receptors, there are no benefits that have yet to be associated with a2 receptor... 

A variety of relatively uncommon dermatological side effects have been noted to be associated with antipsychotic agents. These include maculopapular rashes, urticaria, and erythema multiforme (Arana, 2000). Photosensitivity and skin pigmentation can also occur during treatment with these drugs. Although skin pigmentation has been most frequently reported with chlorpromazine, this can occur with thioridazine and trifluoperazine (Harth and Rapoport, 1996). In addition, treatment-induced alopecia has been reported for haloperidol, olanzapine, and risperidone (Mercke et ah, 2000). 

Atypical neuroleptics have a better side-effect profile, and several studies have confirmed their efficacy. Risperidone has been found effective in the treatment of dementia in patients with agitation (N. Hermann et al. 1998 Jeanblanc and Davis 1995 Jeste et al. 1996 I. R. Katz et al. 1999 Lavretsky and Sultzer 1998), in patients with Lewy body disease (Geizer and Ancill 1998), or in patients with L-dopa-induced hallucinations (Meco et al. 1994). Risperidone has better tolerability than classic neuroleptics such as thioridazine and haloperidol (Frenchman and Prince 1997). No studies of the efficacy of olanzapine in the treatment of agitation in patients with dementia have been done, but its use is widely advocated. 

Freeman TW, Clothier JL, Pazzaglia P, et al A double-blind comparison of valproate and lithium in the treatment of acute mania. Am J Psychiatry 149 108-111,1992 Frenchman IB, Prince T Clinical experience with risperidone, haloperidol, and thioridazine for dementia-associated behavioral disturbances. Int Psychogeriatr 9 431-435, 1997... 

All conventional antipsychotic medications and risperidone may cause hyperprolactinemia. Side effects mediated, at least in part, by hyperprolactinemia include gynecomastia, galactorrhea, amenorrhea, and decreased libido. Thioridazine may cause painful retrograde ejaculation. 

Dwight et al. (291) reported their experience with risperidone in eight patients with schizoaffective disorder (six bipolar type two depressive type). All six bipolar type patients showed the onset of or an increase in mania shortly after starting risperidone (mean number of treatment days = 7 3 mean dose = 7 1 mg/day). In this context, O Croinin et al. (292) reported on a chronic paranoid schizophrenic patient who was admitted in an acute psychotic state unresponsive to thioridazine or CPZ. Risperidone was started (6mg/day by day 3), but by the end of the first week she was displaying hypomanic symptoms. When risperidone was discontinued and haloperidol introduced, her hypomanic symptoms resolved. 

Risperidone, parenteral (Risperdal Constra) Thioridazine (Mellaril) Thiothixene (Navane) Trifluoperazine (Stelazine)... 

Hyperlipidemia associated with antipsychotic drugs has been reviewed (SEDA-29, 64). Haloperidol and the atypical antipsychotic drugs ziprasidone, risperidone, and aripiprazole would be associated with lower risks of hyperlipidemia, whereas chlorpromazine, thioridazine, and the atypical drugs quetiapine, olanzapine, and clozapine would be associated with higher risks. However, severe clozapine-induced hypercholesterolemia and hypertriglyceridemia has been reported in a patient taking clozapine (55). 

There has been one comprehensive meta-analysis including over 80 studies and over 30 000 patients (814). A meta-analysis of trials of neuroleptic drugs showed the following mean weight gains in kg after 10 weeks of treatment clozapine, 4.5 olanzapine, 4.2 thioridazine, 3.2 sertindole, 2.9 chlorpromazine, 2.6 risperidone, 2.1 haloperidol, 1.1 fluphenazine, 0.43 ziprasidone 0.04 molindone, —0.39 placebo, —0.74... 

Galactorrhea associated with a rise in prolactin occurred after a few weeks of treatment with risperidone in two women aged 24 and 39 (1021). One of them was switched to thioridazine, with an improvement in the galactorrhea, and the other continued to take risperidone owing to a robust response her galactorrhea was partially treated with bromocriptine. 

Moban) olanzapine (Zyprexa) perphenazine (Trilafon) pimozide (Orap) quetiapine (Seroquel) risperidone (Risperdal) thioridazine (Mellaril) thiothixene (Navane) trifluoperazine (Stelazine) trifuluopromazine (Vesprin) ziprasidone (Geodon). 

In the development of new antipsychotics, cQT intervals are routinely evaluated but it is currently unclear how predictive these are of clinically significant cardiotoxicity or sudden death. For this reason, the heart rate variability (HRV) index has been developed. It has been shown that the HRV decreases after TCAs and clozapine. In a comparison of the acute effects of olanzapine, risperidone and thioridazine in healthy male volunteers, olanzapine was shown to increase, thioridazine to decrease while risperidone was without effect on the HRV. A decrease in the HRV is an established predictor of poor cardiac outcome. The cardiac changes were unrelated to the degree of sedation caused by the drugs. 

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