DR Medhat MRCP

• Examples of typical antipsychotics :
Haloperidol (Haldol).
Benperidol (Anguil).
Timiperone (Celmanil).
Phenothiazines e.g chloropromazine (largactil) , Acepromazine.
Atypical antipsychotics
- Atypical antipsychotics should now be used first-line in patients with schizophrenia,
according to 2005 NICE guidelines.
- The main advantage of the atypical agents is a significant reduction in extra-pyramidal
side-effects.
• Adverse effects of atypical antipsychotics
Weight gain
Clozapine is associated with agranulocytosis (see below)
When used in elderly :
1) Increased risk of stroke (especially olanzapine and risperidone)
2) Increased risk of venous thromboembolism
• Examples of atypical antipsychotics:
Clozapine (Clozaril) :
- SE :
1. Agranulocytosis ( 1% ) & Neutropenia (3%) so, needs CBC monitoring, used
only in cases resistant to other antipsychotics).
2. Seizure ( in 3% of patients).
‏(سؤال Olanzapine (Zyprexa).(it acts on serotonin `5HT` receptors > D2 receptors
Risperidone (Risperdal).
Quetiapine (Seroquel).
Amisulpride (Solian).
Electroconvulsive therapy :
- Electroconvulsive therapy is a useful treatment option for patients with severe
depression refractory to medication or those with psychotic symptoms.
- The only absolute contraindications is raised intracranial pressure.e.g within 3 months
after stroke
• Short-term side-effects
Long-term side-effects
1- Headache , seizures 1- Impaired memory
2- Nausea
3- Short term memory impairment
4- Cardiac arrhythmia
سؤال
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