ATYPICAL ANTIPSYCHOTICS (Second generation Antipsychotics)
DOSAGE EQUIVALENTS AND SIDE EFFECTS FOR “ATYPICAL” ANTIPSYCHOTICS
|Antipsychotic Drug||Usual Adult Dose||Available strengths||Sed||EPS||AC||Weight gain|
300,400, XR-50, 150,200,300,400
|10-20mg||5 & 10mg sublingual tab||low||low||min||low|
|6-12mg BID||1,2,4,6,8,10,12 mg tablets||low||low||none||mod|
|3-4mg/day||Tablets: 0.25, 0.5, 1, 2 mg, 3 and 4 mg||low||low||low||Mod|
SIDE EFFECT ABBREVIATIONS:
EPS: extrapyramidal side effects
AC: anticholinergic side effects—note the more anticholinergic side effects, the less EPS
SED: sedation or drowsiness.
OVERVIEW of SECOND GENERATION (Atypical) ANTIPSYCHOTICS
- The mechanism of action of most second-generation antipsychotic appears to be blocking the dopamine D2 receptors.
THE MOST COMMON DRUGS —-Highlights
Clozapine (Clozaril) Is considered to be the MOST EFFECTIVE treatment for schizophrenia. However, it has the worst side effect profile.
Monitoring: white blood cells can be affected with a risk of (1%). Reserve this drug for severely ill schizophrenic patients who fail on standard treatment or may be re-experiencing suicidal behavior. Worst for weight gain. Must be dispensed in a registered clinic, that monitors blood work.
Olanzapine (Zyprexa)- after clozapine, considered to be the most effective. More effective than other 2nd generation antipsychotics. Weight gain almost as significant as clozapine. Minimal effect on QT-interval
Risperidone (Risperdal)- most believe it is third in line with regard to efficacy. Causes weight gain. Worst drug for Parkinson’s induced psychosis. May affect hormone balance.
Aripiprazole (Abilify)- may cause some weight gain. Can cause headache, constipation, sexual side effects and restlessness. May cause compulsive sexual behavior, shopping and eating. Is the first antipsychotic approved for major depressive disorder, not just bipolar disorder. Can be added to antidepressants to augment their effects
In the chart above the drugs that are available as generics are in bold. Any drug older than Invega (paliperidone) are available generically. We have more and better drugs available generically, which will save you big money. Thompson Pharmacists are concerned about your physical and mental health. Go Ahead and ASK, at Thompson Pharmacy its ALL for YOU!