Antipsychotics, Mood Stabilisers & Key Concepts – Vocabulary Set

32 vocabulary flashcards summarising major drugs, classes, side-effects and special considerations from the Western NSW MHDA quick-reference guide.

Atypical antipsychotic

Second-generation antipsychotic (e.g., olanzapine, risperidone) with lower EPSE risk but more metabolic effects than conventional agents.

Conventional antipsychotic

First-generation antipsychotic (e.g., haloperidol, chlorpromazine) associated with higher rates of EPSE and prolactin elevation.

Amisulpride

Atypical antipsychotic 50–1200 mg/day for schizophrenia (esp. negative symptoms) and bipolar disorder; raises prolactin, can cause parkinsonism and akathisia.

Aripiprazole

Partial-agonist atypical antipsychotic 10–30 mg/day or monthly LAI 300–400 mg for schizophrenia & bipolar disorder; common side effects: akathisia, insomnia, dizziness.

Asenapine

Sublingual atypical antipsychotic 5–10 mg twice daily for schizophrenia & bipolar disorder; causes mouth tingling, sedation, weight gain, prolactin rise.

Brexpiprazole

Atypical antipsychotic 2–4 mg/day for schizophrenia; side effects include akathisia and dyspepsia.

Cariprazine

Atypical antipsychotic 1.5–6 mg/day for schizophrenia & bipolar disorder; notable for akathisia and dizziness.

Clozapine

Treatment-resistant atypical antipsychotic 25–800 mg/day; requires registry; causes sedation, hypotension, weight gain, hypersalivation, metabolic & cardiac effects, neutropenia.

Chlorpromazine

Low-potency conventional antipsychotic 200–900 mg/day for psychosis & mania; highly sedating with anticholinergic, hypotensive and photosensitivity effects; prolongs QT.

Droperidol

Short-acting injectable antipsychotic for acute behavioural disturbance; strong QT-prolongation and EPSE risk.

Flupentixol

Conventional antipsychotic depot 20–40 mg IM every 2 weeks; used for psychosis; may cause EPSE and prolactin elevation.

Haloperidol

High-potency conventional antipsychotic oral 1–20 mg/day or IM 5–10 mg PRN; strong EPSE and QT-prolongation potential.

Lurasidone

Atypical antipsychotic 40–160 mg/day with food for schizophrenia; common EPSE and sedation.

Olanzapine

Atypical antipsychotic 5–30 mg/day or LAI 150–405 mg q2-4 wks for schizophrenia & bipolar; worst for weight gain and metabolic syndrome; risk of Post-Injection Syndrome.

Paliperidone

Active risperidone metabolite; tablets 3–12 mg/day or LAI 50–525 mg; renally cleared; raises prolactin and causes EPSE, weight gain.

Quetiapine

Atypical antipsychotic 50–800 mg/day (IR/XR) for schizophrenia, bipolar & depression; marked sedation at low doses; weight gain and metabolic effects possible.

Risperidone

Atypical antipsychotic 0.5–6 mg/day or LAI 25–50 mg q2 wks; high prolactin elevation, EPSE, moderate weight gain.

Ziprasidone

Atypical antipsychotic 40–160 mg/day with food or IM 10–20 mg; associated with QT prolongation and akathisia.

Zuclopenthixol

Conventional antipsychotic available as oral, acetate STAT IM (Acuphase), or depot; sedative effects begin after 2 h, peak 12 h, last up to 72 h; EPSE & prolactin rise common.

Long-acting injection (LAI)

Depot formulation administered every weeks or months (e.g., paliperidone, aripiprazole, olanzapine) to sustain antipsychotic levels and improve adherence.

Akathisia

Subjective inner restlessness with inability to stay still; common with aripiprazole, cariprazine, haloperidol; treat with beta-blockers or benzodiazepines.

Extrapyramidal side effects (EPSE)

Drug-induced movement disorders (dystonia, parkinsonism, tardive dyskinesia) especially with conventional antipsychotics and high doses.

Hyperprolactinemia

Elevated serum prolactin from dopamine blockade (e.g., risperidone, paliperidone); can cause galactorrhoea, amenorrhoea, sexual dysfunction.

QT prolongation

Lengthening of cardiac repolarization on ECG; risk with many antipsychotics (haloperidol, droperidol, ziprasidone) and interacting drugs; may lead to torsades de pointes.

Anticholinergic effects

Side effects such as dry mouth, constipation, blurred vision, urinary retention; prominent with clozapine, chlorpromazine, pericyazine.

Mood stabilizer

Medication that treats mania and prevents mood episodes in bipolar disorder (e.g., lithium, valproate, carbamazepine, lamotrigine).

Lithium

First-line mood stabilizer 250–1000 mg/day (target 0.4–1.2 mmol/L); causes tremor, polyuria, weight gain; monitor renal & thyroid; toxicity with NSAIDs, ACE-I, diuretics.

Valproate

Anticonvulsant mood stabilizer 600–2000 mg/day; side effects weight gain, tremor, alopecia, hepatotoxicity; highly teratogenic; interacts with lamotrigine and carbamazepine.

Carbamazepine

Anticonvulsant mood stabilizer 200–1600 mg/day; potent enzyme inducer lowering many drug levels; causes dizziness, hyponatraemia, rash; teratogenic.

Lamotrigine

Anticonvulsant for bipolar depression; slow titration 25–400 mg to avoid severe rash (Stevens–Johnson); valproate increases levels.

Post-Injection Syndrome (PIS)

Rare sedation/delirium event after olanzapine LAI; requires 2–3 h post-dose observation.

Weight gain (antipsychotic)

Metabolic adverse effect prominent with olanzapine, clozapine, quetiapine; monitor BMI, lipids and blood glucose regularly.

Renal clearance

Drug elimination via kidneys; agents like amisulpride and paliperidone need dose adjustment in renal impairment.

Carbamazepine drug interactions

Strong CYP450 inducer that lowers levels of many antipsychotics and mood stabilizers; careful monitoring and dose adjustments required.