Medications available in this class include risperidone (Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa), ziprasidone (Zeldox), paliperidone (Invega), aripiprazole (Abilify) and clozapine (Clozaril).
Clozapine, which has the strongest antipsychotic effect, can cause neutropenia.
The high-potency, first-generation antipsychotics, such as fluphenazine, trifluoperazine, haloperidol, loxapine, pimozide, perphenazine, and thiothixene, are dosed in the range of one to tens of milligrams. They display low activity at histaminic and muscarinic receptors.
Quetiapine abuse is relatively common, and is abused far more often than any other second-generation antipsychotic. Emergency physicians should be aware of the clinical effects that may occur after second-generation antipsychotic abuse.
In general, the high-milligram, low-potency antipsychotics, such as chlorpromazine and mesoridazine, produce more sedation than the low-milligram, high-potency antipsychotics such as haloperidol and fluphenazine (Table 1). This principle tends to hold true for the atypical antipsychotics as well.
Atypical antipsychotics such as quetiapine, aripiprazole, olanzapine, and risperidone have been shown to be helpful in addressing a range of anxiety and depressive symptoms in individuals with schizophrenia and schizoaffective disorders, and have since been used in the treatment of a range of mood and anxiety disorders ...
Drugs with the fastest onsets include haloperidol, risperidone, and olanzapine, with onsets appearing in 2 6 days. Chlorpromazine and thiothixene were at the slowest end of the continuum, with onsets of 2 weeks or longer.
Of the atypical antipsychotics, risperidone is the weakest in terms of atypicality criteria.
Haldol (haloperidol) and Thorazine (chlorpromazine) are the best known typical antipsychotics.
Medications available in this class include risperidone (Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa), ziprasidone (Zeldox), paliperidone (Invega), aripiprazole (Abilify) and clozapine (Clozaril).
Second-Generation Antipsychotics
These can be administered in oral or parenteral forms. Risperidone, olanzapine, aripiprazole, and paliperidone are available as extended-release or long-acting injectable forms. Clozapine, asenapine, and olanzapine are available in the sublingual formulation.
More than seventy years after its discovery, lithium remains the most effective medication in all of psychiatry, with a response rate of more than 70% for patients with bipolar disorder. It also has useful applications in the treatment of unipolar depressions.
Over the past decade a growing research literature has suggested that second-generation antipsychotics such as clozapine, olanzapine, risperidone, quetiapine and ziprasidone are effective in the treatment of patients with psychosis, including those expressing hostility, aggression and violent behaviour.
Olanzapine-fluoxetine combo (OFC) (Symbyax)
Statistically speaking, OFC may be the most effective therapy for acute bipolar depression, with a number needed to treat (NNT) of 2 compared with 5 to 11 for other FDA-approved atypical antipsychotics.
Clozapine is the most effective antipsychotic in terms of managing treatment-resistant schizophrenia. This drug is approximately 30% effective in controlling schizophrenic episodes in treatment-resistant patients, compared with a 4% efficacy rate with the combination of chlorpromazine and benztropine.
51% and 23% on antipsychotics had a “minimal” or “good” response to treatment, versus 23% and 14% on placebo; medications better, but not as good as one would like.
Tardive psychosis is a term used to describe new psychotic symptoms that begin after you have been taking antipsychotics for a while. Some scientists believe that these symptoms may be caused by your medication, not your original illness returning.
Antipsychotics were discovered in the late 1950s. This first antipsychotic drug, chlorpromazine, was first developed as a “tranquilizer.” Its usefulness for treating psychosis was recognized by accident.
While not a certainty, long‐term antipsychotic treatment is a very common outcome for people with schizophrenia.
Generally, the use of two or more antipsychotic medications concurrently should be avoided except in cases of three failed trials of monotherapy, which included one failed trial of clozapine where possible, or where a second antipsychotic medication is added with a plan to cross-taper to monotherapy.
Benzodiazepines (also known as tranquilizers) are the most widely prescribed type of medication for anxiety. Drugs such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam) work quickly, typically bringing relief within 30 minutes to an hour.
Commonly prescribed SSRIs include sertraline and citalopram. Side effects may include insomnia, anxiety, nausea, sexual dysfunction, and diarrhea. Medications known as atypical antidepressants may also be prescribed to manage some anxiety disorders. These medications include bupropion and mirtazapine.
Antipsychotics are a class of drugs used commonly to treat psychotic disorders -- conditions in which thinking can be irrational, and people have false beliefs (delusions) or perceptions (hallucinations) -- and sometimes to treat mood disorders such as bipolar disorder or major depression.