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What is the main NT issue with Schizophrenia?
Overactive dopamine pathways.
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Clozapine
- Clozaril
- Blocks D4 receptors
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Haloperidol
- Haldol
- Traditional antipsychotic
- Increased extrapyramidal motor side effects
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Fluphenazine
- Prolixin.
- Traditional antipsychotic
- Increased extrapyramidal motor side effects
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Chlorpromazine
- Thorazine
- Traditional antipsychotic
- Less potent, causes less motor side effects
- Has Sedative and anticholinergic effets
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Thioridazine
- Mellaril
- Traditional antipsychotic
- Less potent, causes less motor side effects
- Has Sedative and anticholinergic effets
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Clozapine
- Clozaril
- Atypical antipsychotic
- Blocks D2 and has less side effects, usually first choice.
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Risperidone
- Risperdal
- Atypical antipsychotic
- Blocks D2 and has less side effects, usually a first choice
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If antipsychotic drugs aren't given orally they are usually taken...
Intramuscular injections "depot administration"
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Most feared side effect of antipsychotics
- Tardive dyskinesia
- Involuntary and fragmented movements
- Reserpine is often used to alleviate symptoms
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Resting tremor, bradykinesia, rigidity
Pseudoparkinsonism
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Motor restlessness, agitation, insomnia
- Akathisia
- Propranolol (Inderal) beta-2 adrenergic receptor blocker is used to help with this side effect
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Broad range of involuntary and uncoordinated movements
- Dyskinesias and dystonias
- May use antiparkinsons or benzo to treat
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NMS
- Neuroleptic malignant syndrome
- Catatonia, rigidity, tremor, stupor, fever.
- Stop the use.
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