Introduction to An Overview of Antipsychotic Drugs Definition of psychosis, Causes of psychosis, Symptoms of psychosis, Classification of anti psychotic drugs, Mechanism of action, Pharmacokinetics, Adverse effects, Therapeutic uses, Contraindications, New inventions Presented by T. Niranjan Reddy Department of Pharmacology

1. Raghavendra Institute of Pharmaceutical Education and Research - Autonomous
K.R.Palli Cross, Chiyyedu, Anantapuramu, A. P- 515721
A Seminar as a part of curricular requirement for
M . Pharmacy I year I Semester
Presented by
T.Niranjan Reddy
(20L81S0109)
Department of Pharmacology
Under the guidance of
Mr . A .Sudheer Kumar M.Pharm .
Associate Professor

2. RIPER
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SIRO- DSIR
Raghavendra Institute of Pharmaceutical Education and Research - Autonomous
K.R.Palli Cross, Chiyyedu, Anantapuramu, A. P- 515721
Contents :
 Introduction
 Definition of psychosis
 Causes of psychosis
 Symptoms of psychosis
 Classification of anti psychotic drugs
 Mechanism of action
 Pharmacokinetics
 Adverse effects
 Therapeutic uses
 Contraindications
 New inventions
 References
2

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Raghavendra Institute of Pharmaceutical Education and Research - Autonomous
K.R.Palli Cross, Chiyyedu, Anantapuramu, A. P- 515721
Introduction:
 The psychosis usually involves severe symptoms such as delusions
and paranoia. The common belief that anyone who goes crazy or
aggressive must be psychotic is not strictly correct in medical
terminology.
 Psychotic disorders focus mainly on the symptoms where the person
is detached from reality
 About 12-23 percentage of people experience psychotic symptoms
at some point in their lives.
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K.R.Palli Cross, Chiyyedu, Anantapuramu, A. P- 515721
DEFINITION
 Psychosis refers to an abnormal condition of the mind described as
involving a “loss of contact with reality”
 The word Psychosis derived from the Greek i.e,“ psyche” means
mind/ soul and osis - abnormal condition.
 People experiencing psychosis may exhibit some personality
changes and thought disorder.
 Depending on its severity, this may be accompanied by unusual or
bizarre behaviour, as well as difficulty with social interaction and
impairment in carrying out daily life activities.

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 The causes of psychosis can be different for everyone, and the exact cause
is not always clear . Psychosis could be triggered by the number of factors,
such as;
 Genetics
 Trauma
 Psychiatric disorder
 Medical conditions
 Psychoactive drugs (alcohol etc)
 Medication
Causes of psychosis:

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Signs and symptoms of psychosis
INTIAL SYMPTOMS
 Feeling of suspicion
 General anxiety
 Depression
 Obsessive thinking
 Distorted perceptions
 Obsessive thinking

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 Hallucinations
 Delusions
 Disorganization in thought, speech or behaviour
 Disordered thinking
 Catatonia
 Difficulty in concentrating
Main symptoms:

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• Schizophrenia
• Bipolar disorder
• Psychotic depression
• Schizoaffective disorder
• Substance induced psychosis
• Schizophreniform disorder
• paraphrenia
Types of psychotic disorders:

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Schizophrenia:
 It is one of the most common type of psychotic disorder
 The main symptoms are hallucinations (you hear voices or see
things that are not real) and delusions (strong beliefs in things
hat are not true).
Schizoaffective disorder:
It is a condition where you can experience both schizophrenia and a
mood disorder (depression and bipolar disorder).
Bipolar disorder:
It is a type of mood disorder that is often characterised by cyclic
changes between extreme highs (mania) and low (depression).

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Substance induced psychotic disorder:
 When you start or stop certain drugs, you may get substance induced
Psychotic disorder. The symptoms include hallucinations and delusions.
Drugs which an cause these type of disorder are
 alcohol
 amphetamines
 cocaine
 LSD
 opioids
Paraphrenia:
 It is similar to schizophrenia that can be seen in the elderly patients with
the age group of 40
 It is characterized by paranoid delusions and hallucinations.
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 Anti psychotic drugs are also known as neuroleptics or major
tranquilizers are a class of medications primarily used to manage
psychosis principally in schizophrenia and bipolar disorder
• First generation antipsychotics known as typical antipsychotics were
discovered in the 1950s
• Second generation drugs known as atypical antipsychotics were
discovered in 1960s and introduced clinically in the 1970s.
Anti psychotic drugs:

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• Pharamacological classification
first generation antipsychotic (low potency)
• Chlorpromazine
• Prochlorperazine
• Thioridazine
First generation antipsychotic (high potency)
• Fluphenazine thiothixene
• Haloperidol Pimozide
Second generation antipsychotics
• Aripiprazole olanzapine
• Asenapine quetiapine
• Clozapine risperidone
• Lurasidone ziprasidone
Classification of anti psychotic drugs:

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Mechanism of action:

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 Oral absorption of chlorpromazine is somewhat unpredictable
and bioavailability is low
 It is highly bound to plasma as well as tissue proteins
 Volume of distribution therefore is large (20LKG)
 It is metabolized in liver mainly by CYP 2D6 into a number of
metabolites
 The acute effects of a single dose of chlorpromazine generally last
for 6-8 hours
 The t12 ( elimination )half life is usually 18-30 hours
 The metabolites are excreted in urine and bile.
Pharmacokinetics

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Adverse effects
• Drowsiness, lethargy, mental confusion with low potency typical
antipsychotics and some atypical ones like quetiapine and clozapine
• Increased appetite and and aggravation of seizures in epileptics
• Weight gain
• Orthostatic hypotension, palpitation, Q-T interval prolongation and
cardiac arrythmiasis
• Dry mouth and blurred vision
• Constipation and urinary retention
• Extrapyramidal symptoms such as pseudo parkinsonism , akinesia
(muscular weakness), akathisia (continuous restlessness and
fidgeting) and dystonia (involuntary movements of face, legs , arms
and neck).
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Therapeutic uses:
 Used to treat schizophrenia
 Used in the prevention of severe nausea and vomiting
 Used to treat depression and mania
 Chlorpromazine is used to treat intractable hiccups
 Risperidone and haloperidol are also commonly prescribed
for this tic disorder
 Used to treat alcoholic hallucinations.
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contraindications:
These drugs are contraindicated in
• Hypotension
• CNS depression
• Pregnant women
• Liver, renal or cardiac insufficiency.
NEW INVENTIONS:
• Paliperidone
• Asenapine
• Lurasidone
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References :
• TRIPATHI , K.D. “Essentials of Medical Pharmacology Textbook
of pharmacology 7th edition 2013 p.463.
• eucht, S. et al. Second-generation versus first-generation
antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 373,
31–41 (2009).
• Emsley R, Rabinowitz J, Medori R. Time course for antipsychotic
treatment response in first episode schizophrenia. Am J
Psychiatry 2006
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