Antipsychotics – Typical and Atypical (First Aid 2025 High-Yield Summary)

Flashcards covering typical and atypical antipsychotics: MOA, clinical uses, and adverse effects as described in the notes.

Name the low-potency typical antipsychotics.

Chlorpromazine and Thioridazine.

What is the general MOA of typical antipsychotics (both low- and high-potency)?

D2 receptor antagonists that inhibit dopamine signaling, leading to increased cAMP.

What are the clinical uses of low-potency typical antipsychotics?

Schizophrenia (positive symptoms), psychosis, mania, Tourette syndrome.

What are the unique adverse effects associated with thioridazine and chlorpromazine?

Thioridazine → retinal deposits; Chlorpromazine → corneal deposits.

Name the high-potency typical antipsychotics.

Haloperidol, Fluphenazine, Trifluoperazine.

What are the clinical uses of high-potency typical antipsychotics?

Schizophrenia, acute psychosis, agitation, Tourette syndrome.

What are the common adverse effects of high-potency typical antipsychotics?

Extrapyramidal symptoms (dystonia, akathisia, parkinsonism, tardive dyskinesia), neuroleptic malignant syndrome (NMS), hyperprolactinemia.

Clozapine MOA and primary use.

Weak D2 and 5-HT2A antagonism; used for treatment-resistant schizophrenia and suicidality in schizophrenia/schizoaffective disorder.

What are the serious adverse effects of Clozapine?

Agranulocytosis (weekly CBC), seizures, myocarditis, weight gain, metabolic syndrome.

Which atypical antipsychotics exhibit D2 and 5-HT2A antagonism and what are their uses?

Olanzapine and Quetiapine; used in schizophrenia, bipolar disorder, and Quetiapine as an adjunct for treatment-resistant depression.

What are the adverse effects of Olanzapine and Quetiapine?

Weight gain, metabolic syndrome, sedation.

Risperidone MOA and clinical uses.

D2 + 5-HT2A antagonism; used in schizophrenia, bipolar disorder, and autism-associated irritability.

What are the adverse effects of Risperidone?

Hyperprolactinemia (gynecomastia, amenorrhea, galactorrhea) and metabolic syndrome.

Aripiprazole MOA and clinical uses.

Partial D2 agonist, 5-HT1A agonist, 5-HT2A antagonist; used in schizophrenia, bipolar disorder, depression (adjunct), and Tourette syndrome.

What are the adverse effects of Aripiprazole?

Lower metabolic risk; akathisia possible.

Ziprasidone and Lurasidone MOA and uses.

D2 + 5-HT2A antagonism; used in schizophrenia, and lurasidone for bipolar depression.

Which antipsychotic is particularly associated with QT prolongation, especially among the atypicals?

Ziprasidone.

Which atypical antipsychotics are noted to have lower metabolic risk?

Aripiprazole, Ziprasidone, and Lurasidone.