Antipsychotic drugs are used in the treatment of psychotic symptoms like delusions(abnormal thought), hallucinations (abnormal perception), abnormal mood and behaviour, affect disturbance, social withdrawal etc .
Antipsychotic drugs are mainly used in conditions like :
1. Schizophrenia
2. Psychosis
3. severe depression
4. Mania with psychotic symptoms
2. DEFINITION
● Antipsychotics are those psychotropic
drugs which are used to treat
psychotic symptoms such as delusions,
hallucinations and disordered thought.
● Other names of Antipsychotics:-
➢ Neuroleptic
➢ Major tranquilizers
➢ D2 receptor blockers
➢ Antischizophrenic
● First antipsychotic was
Chlorpromazine.
5. TYPICAL ANTIPSYCHOTICS
● These are first generation drugs.
● They are D2 receptor blockers.
● They are effective for positive symptoms.
➔ Hallucinations
➔ Delusions
➔ Bizarre behaviour
➔ Disturbed thoughts
● High incidence of extrapyramidal reaction
6. 1. Phenothiazine derivatives:-
❏ Chlorpromazine
1500mg/ day oral or 50-100 mg/ day IM
❏ Promethazine
12.5-25 mg (oral)
25-50 mg/mL (parenteral)
❏ Prochlorperazine
5-10 mg (oral )
20-30 mg (parenteral)
8. ATYPICAL ANTIPSYCHOTICS
These are second generation antipsychotics.
● They are 5-HT, D4 receptor blockers, i.e
Serotonin-dopamine antagonist (SAD).
● Effective for negative symptoms.
● Low incidence for extrapyramidal
reaction.
● They are more efficient than typical
antipsychotics, having less side effects.
9. Contd…
● These include :
➢ Olanzapine (5-20mg/day oral)
➢ Clozapine(50-450mg/day oral)
➢ Risperidone (2-10mg/day oral)
10. MECHANISM OF ACTION
● Antipsychotic drugs block the dopamine
D2 receptors (typical antipsychotics) and
5-HT receptors (atypical antipsychotics)
in the mesolimbic area of the brain.
● Decreased dopamine is responsible for
negative and depressive symptoms of
schizophrenia.
11. INDICATIONS OF
ANTIPSYCHOTIC
S
❏ Primary Indications
Common conditions in which
antipsychotic might be used are:-
● Schizophrenia.
● Schizoaffective disorder.
● Bipolar disorder.
● Delusional disorders.
● Psychotic depression.
12. Contd…
❏ Secondary indications or
additional use i.e non-
psychotic disorders:-
● ASD
● ADHD
● Treatment resistant
● OCD
● Dementia
● General anxiety disorder
13. ● CNS depression.
● Bone marrow depression.
● Hypotension.
● Parkinsonism.
● Hepatic dysfunction.
● Glaucoma.
CONTRAINDICATIONS OF
ANTIPSYCHOTICS
15. PHARMACOKINETICS
Can be given by different routes i.e orally, by tablet or syrup and
by IM injection, IV injection can be very irritating.
● Absorption : rapidly absorb in GI tract.
● Metabolism : liver.
● Excretion : liver and kidney.
16. SIDE EFFECTS OF
ANTIPSYCHOTICS
❖ Extra pyramidal reaction
❏ Drug induced movement
disorder
❏ Pseudoparkinsonism
❏ Akathisia
❏ Facial dyskinesia
❏ Acute dystonia
20. ● Instruct the patient to take sips of water frequently to relieve
dryness of mouth.
● A high-fiber diet, increased fluid intake and laxatives, if needed,
help to reduce constipation.
● Observe the patient regularly for abnormal movements.
21. ● Take all seizure precautions.
● Advise the patient to get up from the bed or chair very
slowly.This is an important measure to prevent falls and
other complications resulting from orthostatic hypotension.
● The patient should also be told to report if sore throat or
fever develop, which might indicate infection.
