Antipsychotics, antipsychotic drugs, major tranquilizers, tranquilizers
introduction, indication, contraindications and side effects of antipsychotic drugs are explained.
Antipsychotic drugs used in the treatment of schizophrenia including psychosis is described.
• Acute and chronic psychoses, particularly
when accompanied by increased
• Selected agents used as antiemetics
• Interactable hiccoughs (chlorpromazine,
• Tics and vocal utterances in Tourette’s
disorder (haloperiod, pimozide)
• The exact mechanism is not known.
• Blocking postsynaptic dopamine receptors in
the basal ganglia, hypothalamus, limbic
system, brainstem, and medulla.
• Newer medications may exert antipsychotic
properties by blocking action on receptors
specific to dopamine, sertonin, and other
• Inhibition of Dopamine mediated
transmission of neural impulses
• Known hypersensitity
• Should not be used when CNS depression is
• Blood dyscrasias
• Parkinson’ disease
• Liver/renal/cardiac insufficiencies.
• Elderly, severely ill or debilitated
• Diabetic, respiratory insufficiency, prostatic
hypertrophy, or intestinal obstruction.
• Safety in pregnancy and lactation has not been
• Additive anticholinergic effects are observed when
antipsychotics are taken concurrently with other
drugs that produce these properties.
• Additive hypotensive effect with beta-adrenergic
• Antacids and antidiarrheals may decrease
absoption of antipsychotics.
• Barbiturates may increase metabolism and
decrease effectiveness of antipsychotics.
• Additive CNS depression with alcohol, sedative
hypnotics and anxiolytics.
• Risk for other-directed violence related t
panic anxiety and mistrust of others.
• Risk for injury related medication side effects
• Risk for activity intolerance related to
medication side effects of sedation, blurred
vision and weakness
• Noncompliance with medication regimen
related to suspiciousness and mistrust of
Side effects (contd..)
• ECG changes: prolongation of the QT
interval, are possible with most of the
– Caution: patient with arrhythmias
• Reduction of seizure threshold.
– Clozapine: weekly/biweekly blood
• Hypersalivation (clozapine)
– Tremor, shuffling gait, drooling, rigidity.
– 1-5 days after initiation of antipsychotics
• Akathisia (50-60 days after initiation of therapy)
– Men; <25
• Oculogyric crisis
– Treated as emergency
– Physician should be contacted immediately
– IV benztropine mesyulate
• Tardive dyskinesia
Side effects (contd..)
• Neuroleptic malignant syndrom (NMS)
– Severe parkinsonian muscle ridigidity
– Upto 1070
C, tachycardia, tachypnea
– Fluctuations in blood pressure, diaphoresis, and
rapid deterioration of mental status to stupor and
– This is rare but potentially fatal complication of
treatment with neuroleptic drugs.
– Within hours – year after drug initiation.]
– Discontinue neuroleptic immediately.
– Bromocryptine or dantrolene
• Indicated for the treatment of all forms of
parkinsonism and for the relief of drug-
induced extrapyramidal reactions.
• Restoring the natural balance of two major
neurotransmitters in the CNS: Ach,
• Deficiency in dopamine results in
excessive cholinergic activity.
• Anticholinergics or dopaminergic agonists.