Anti psychotics & anti manic drugs, psychosis, neurosis, delusions, hallucinations, schizhophrenia, positive and negative symptoms of schizophrenia, dopamine hypothesis,

2. Anti psychotics and
anti manic drugs
Dr. Resu Neha Reddy
Final Yr PG
Dept. of Pharmacology
Osmania Medical
College

3. Objectives
 Classify Antipsychotic drugs
 Describe mechanism of action
 Enumerate pharmacological actions
of Chlorpromazine
 Differentiate typical and atypical
anti psychotics
 Management of Schizhophrenia and
 Manic depressive psychosis

4. Psyche or mind
Three functions of mind
 Cognition
 Affect
 Conation

5. Psychopharmacology
branch of Pharmacology that deals
with drug therapy of psychiatric
disorders

6. Psychosis vs Neurosis
Psychosis: severe psychiatric
disorder
 Marked impairment of behaviour
 Inability to think coherently,
comprehend reality and
 Lack of insight into these
abnormalities
 Neurosis: Anxiety disorders,
Obsessive compulsive disorder

7. Psycho active drugs
 Anti psychotics- (Neuroleptics)-
used in Schizhophrenia
 Mood stabilizers- used in Manic
depressive psychosis- Lithium
carbonate
 Anti anxiety drugs-(Anxiolytics)-
used in neurotic conditions like panic
disorders, anxiety states
 Anti depressants –(Mood
elevators)-used in depression

8. Symptoms of Psychosis
 Delusions- false belief
 Hallucinations- perception without a
stimulus

9. Schizhophrenia-schizhos-split min
 Idiopathic psychosis characterized by
chronically disordered thinking &
emotional withdrawal and often
associated with delusions and auditory
hallucinations

10. Positive Negative
Hallucinations Affective flattening
Delusions Poverty of
speech/alogia
Bizarre behaviours Anhedonia
Thought disorder Apathy

12. Dopamine hypothesis - Carlsson
2000

13. Dopamine pathways in
brain
 The nigrostriatal pathway
 The mesolimbic/mesocortical pathway
 The tubero-hypophyseal pathway

17. Typical/Classical/Older Anti
psychotics
 Phenothiazines: eg. Chlorpromazine,
Trifluoperazine
 Butyrophenones: Haloperidol,
Trifluoperidol
 Diphenylbutyl piperidines:Pimozide,
Penfluridol
 Thioxanthenes: Chlorprothixene,
Flupentixol
 Indolic derivatives: Molindone, Oxypertine

18. Atypical/Newer/ Second
generation anti psychotics
 Dibenzodiazepines: Clozapine
 Substituted benzamides:
Sulpiride, Risperidone,
Paliparidone
 Miscellaneous: Olanzapine,
Quetiapine, Aripiprazole,

19. Schizhophrenia

21. Chlorpromazine
First anti-psychotic drug
Prototype of typical
anti-psychotics
Causes blockade of D2
receptors in brain
Side effects are many

24. Typical anti psychotics –
adverse effects
 Autonomic nervous system
Muscarinic blockade-dry mouth etc
α adrenergic blockade- orthostatic
hypotension
 Central nervous system- Parkinson’s
syndrome, dystonias, akathisia, tardive
dyskinesia, Rabbit’s syndrome,
Neuroleptic malignant syndrome
 Miscellaneous-hypersensitivity

26. Chlorpromazine -
preparations
 Tablets, syrup, suppositories
 Tablets- 10, 25, 50, 100 mg
 Chlorpromazine injections 25 mg/ ml
( Intra muscular route only)
 Depot phenothiazines

28. Atypical antipsychotics
 Have greater affinity for other
receptors like 5 HT
 Have less incidence of EPS and TD
 Useful for improving negative
symptoms of Schizhophrenia
 Also used in MDP

34. Therapeutic uses
 Schizhophrenia
 Senile psychosis
 Manic depressive psychosis
 Anti emetic
 In Preanaesthetic medication-
Promethazine
 In Neuroleptanalgesia: Droperidol with
Fentanyl
 Tourette syndrome

40. Summary
 Classify Antipsychotic drugs
 Describe mechanism of action
 Enumerate pharmacological actions
of Chlorpromazine
 Differentiate typical and atypical
anti psychotics
 Management of Schizhophrenia and
 Manic depressive psychosis

41. “Writing prescriptions is
easy,
Understanding people is
hard”
-Franz Kafka

42. THANK YOU...