Category:Antipsychotics

From Ganfyd

Antipsychotic medications, also known as neuroleptic medications or major tranquilisers, are used in the treatment of schizophrenia and other psychoses, and are often used in the treatment of mania. Some may also have a use in the management of acutely disturbed patients.

Antipsychotics are generally split into 2 broad groups, although to a degree this has been distorted by marketting rather than science^[1]:

• Typical Antipsychotics
• Atypical Antipsychotics

The typical antipsychotics were discovered first, and although they are effective, many patients find the side-effects, especially extra-pyramidal symptoms in high potency compounds, difficult to tolerate. Other side effects such as obesity may be explained by actions on cyclic AMP related signaling pathways. Atypical antipsychotics tend to cause fewer extra-pyramidal symptoms, and are often better tolerated by patients. For this reason, atypical antipsychotics are now considered the first-line treatment for schizophrenia. There is however no real net cost utility advantage for the two different classes of drugs as most of the cost of psychotic illness is non drug related, and interestingly despite modern practice, at 1 year there is a trend to clinical utility for the typical antipsychotics. ^[2]

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) has defined best choices of drug in patients who fail to respond to a first atypical antipsychotic. This is, if its toxicity and definite health resource premium can be accepted, clozapine ^[3]leptin and if not risperidone and olanzapine are more effective than quetiapine and ziprasidone ^[4]

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