-
High-potency typical antipsychotics: name of medications (5), starting dose, dose range (mg/day), class
- Haloperidol (haldol): 0.5-6mg/day, 2-10, butyrophenone
- Trifluoperazine (stelazine): 2-10mg/day, 5-60, phenothiazine (C)
- Pimozide (orap): 1-2, 1-10, butyrophenone
- Fluphenazine (prolixin): 2.5-10, 5-50, phenothiazine (C)
- Thiothixine (navane): 2-10mg/day, 5-60, thioxanthenes
-
Common side effects associated specifically with high-potency antipsychotics
- dystonia
- akathisia
- parkinsonism
- (less likely to have sedation, hypotension, weight gain, anticholinergic symptoms)
-
Mid-potency typical antipsychotics: name of medications (3), starting dose, dose range (mg/day), class
- Perphenazine (trilafon): 8-24mg/day, 8-64, phenothiazine (C)
- Loxapine (loxitane): 10-50mg/day, 30-250, dibenzapine
- Molindone (Moban): 50-75mg/day, 10-225, indole
-
Low-potency typical antipsychotics: name of medications (3), starting dose, dose range (mg/day), class
- Chlorpromazine (thorazine): 100-200mg/day, 100-2,000, phenothiazine (A)
- Thioridazine (mellaril): 50-300mg/day, 100-600, phenothiazine (B)
- Mesoridazine (serentil): 50-150mg/day, 100-400, phenothiazine (B)
-
Common side effects associated specifically with low-potency antipsychotics
- sedation
- hypotension
- weight gain
- anticholinergic symptoms (dry mouth, urinary retention, constipation, blurred vision)
- (less likely to have dystonia, akathisia, parkinsonism)
-
Side effects of typical antipsychotics (other than those listed previously for high-potency and low-potency agents)
- hyperprolactinemia (amenorrhea, galactorrhea, sexual dysfunction)
- tardive dyskinesia
- NMS
- poikilothermia (impaired heat regulation)
- pigmentary retinopathy (esp thioridazine >800mg/day)
- EKG changes (esp with pimozide, chlorpromazine, and thioridazine)
-
Mechanism of action of typical antipsychotics
D2 antagonism, acutely block 75-90%
-
Different pathways in brain associated with positive symptoms, negative symptoms, and EPS
- nigrostriatal (midbrain to neostriatum): EPS
- mesolimbic (midbrain to limbic structures): positive symptoms
- mesocortical (midbrain to frontal and temporal cerebral cortex pathway): negative symptoms
|
|
