Antipsychotics are medications that control the symptoms of, and behaviors associated with, psychotic disorders such as schizophrenia. Until I started my rotation in psychiatric nursing, I didn't fully appreciate how terrible and distressing psychotic symptoms are to both the patient and their family. To the patient, their hallucinations are as real (or even more real) as what is going on around them. In a typical schizophrenic (if there is such a thing) these hallucinations are not pleasant. They are usually demanding, overwhelming voices telling them to harm themselves or others, threatening visions or similarly bad smells or sensations. Despite the host of bad side effects antipsychotics can have, for many it is a small price to pay for keeping these things at bay.
Antipsychotics
Brand/Generic Drug Names
Aripiprazole, Clozaril/clozapine, Thorazine/chlorpromazine, Compazine/prochlorperazine, Geodon/ziprasidone, promazine, Haldol/haloperidol, Loxitane/loxapine, Mellaril/thioridazine, Moban/molindone, Navane/thiothixene, Orap/pimozide, Prolixin/fluphenazine, Risperdal/risperidone, Serentil/mesoridazine besylate, Seroquel/quetiapine fumarate, Sinequan/doxepin, Stelazine/trifluoperazine, Trilafon/perphenazine, Zyprexa/olanzapine
Common uses
schizophrenia, paranoia, mania, severe anxiety, intractable hiccups, nausea, vomiting, behavioral problems in children, relaxation before surgery
Pharmacology
block postsynaptic dopamine receptors in central nervous system responsible for psychotic behavior
Class contraindications
liver damage, severe hypertension, coronary artery disease, cerebral arteriosclerosis, blood dyscrasias, bone marrow depression, parkinsonism, severe depression, narrow-angle glaucoma, children under 12 yrs, persons withdrawing from alcohol or barbiturates
Class precautions
elderly, hepatic and renal disease, seizure disorders, diabetes mellitus, prostatic hypertrophy, chronic respiratory disease, peptic ulcer disease
Interactions
central nervous system depressants: oversedation
Anticholinergics: decreased phenothiazine, increased anticholinergic effect
Adverse Reactions
extrapyramidal symptoms, tardive dyskinesia, akathisia, hypotension, agranulocytosis, cardiac arrest, laryngospasm, dry mouth, photosensitivity
Additional Information
Assess complete blood count, liver function tests, bilirubin
Assess intake and output, central nervous system status, orthostatic hypotension, extrapyramidal symptoms
Administer Antiparkinson agent if extrapyramidal symptoms occur
Increase fluids, provide hard candy for dry mouth
Evaluate therapeutic response: decreased excitement, hallucinations, delusions, paranoia, reorganization of thought patterns and speech
Date of most recent Update
August 08, 2002
Further information is available in the writeup for the
specific name(s) of this medication class