Anti Psychotics First Gen Anti-Psychotics HIGH POTENCY ANTI-PSYCHOTICS HAL Tried to Fly high ⟶ Haloperidol, Trifluoperazine & Fluophenaazine ⟶ high potency Medications Mechanism of Action Indications Side Effects * Haloperidol Dop. specific antagonism (D 2 -R) * Schizophrenia * Hyperprolactinemia * Fluphenazine * Bipolar * EPS * Perphenazine * Acute Psychosis * Prolonged QT interval * Trifluoperazine * Acute agitated states * Neuroleptic malignant syndrome * Pimozide * Tourette syndrome * Metabolic & anticholinergic effects → less pronounced * OCO * HD LOW POTENCY ANTI-PSYCHOTICS Charaltans & Thieves are lustful Medications Mechanism of Action Indications Side Effects * Chlorpromazine * Dopamine antagonism * Acute agitation * Anti-cholinergic effects: → dry mouth, sore throat & resp tract secretions (due to impaired exocrine Pk) → tachycardia * Thioridazine * Anti-cholinergic * Delirium * ↓ SM tone → reflex, orthostatic, ileus, impaired micturition/urinary retention * Anti-histamine (mainly sedative) → mydriasis & photophobia, blurred vision → CNS → seizures, coma, agitation, excitement, confusion, disorientation sympatholytic effects metabolic effects sedation dominate EPS less common Second Generation Anti-Psychotics Medications Mechanism of Action Indications Side Effects * Olanzapine * D 2 -R antagonism * Schizophrenia * Metabolic effects * Clozapine → less pronounced than FGAs * Bipolar → most prominent * Risperidone * 5-HT 2A -R antagonism * Post-partum psychosis * Prolonged QT syndrome * Quetiapine * D 3 , D 4 , α 1 , α 2 , H 1 -R interactions * Hyperprolactinemia * Amisulpride * D 3 , D 4 , α 1 , α 2 , H 1 -R interactions * MDD with psychotic features → less pronounced than FGAs * Ziprasidone → except amisulpride * Lurasidone * Aripiprazole is a partial D 2 agonist * Tourette Synd. * NMG * Iloperidone * Anxiety * Clozapine → agranulosis & ↓ seizures threshold * Paliperidone D 2 agonist * HD * Sedation, somnolence * EPS less common * Anti-cholinergics & sympatholytic effects