Atypical Antipsychotics Mnemonic | Names, Side Effects & MOA

Atypical Antipsychotics (AAP), also known as second generation antipsychotics (SGAs), include:

  • Aripiprazole: Partial dopamine agonist, used for schizophrenia and bipolar disorder.
  • -apine drug names:
    • Clozapine: Treatment-resistant schizophrenia (TRS)
    • Olanzapine: Schizophrenia, bipolar
    • Quetiapine: Bipolar disorder (depressive and manic episodes), schizophrenia
    • Asenapine: Schizophrenia in adults, bipolar
  • -idone drug names:
    • Risperidone: First episode psychosis, dementia
    • Ziprasidone: Schizophrenia, bipolar, lower weight gain risk
    • Lurasidone: Schizophrenia, bipolar depression, low metabolic risk
    • Iloperidone: Schizophrenia, low sedative effect
    • Paliperidone: Schizophrenia, schizoaffective disorder

Memorize atypical antipsychotics using the mnemonic “CORAL Q ZIP”: C for Clozapine, O for Olanzapine, R for Risperidone, A for Aripiprazole, L for Lurasidone, Q for Quetiapine, Z for Ziprasidone, I for Iloperidone, P for Paliperidone.

For a nursing-focused breakdown of typical antipsychotics mechanism of action and side effects, check out this video:

Adverse Side Effects of Atypical Antipsychotics

  • Extrapyramidal Symptoms (ADAPT)
    • Acute Dystonia: Painful muscle spasms
    • Akathisia: Restlessness and urge to move
    • Parkinsonism: Shaky hands, slow movements
    • Tardive Dyskinesia: Involuntary repetitive movements
  • Metabolic Syndrome: Weight gain, Increased cholesterol, High blood sugar, Insulin resistance
  • Sedation: A common side effect that can impact daily activities.
  • Anticholinergic Effects: Dry mouth, Constipation, Blurred vision , Urinary retention
  • Neuroleptic Malignant Syndrome (NMS): Life-threatening condition with symptoms like: high fever, muscle rigidity, confusion, autonomic instability
  • Agranulocytosis (Clozapine): Severe drop in white blood cell count.Recall common adverse effects of clozapine using the mnemonic WEIGHT: W for Weight gain (metabolic syndrome), E for Excessive drooling (sialorrhea), I for Increased seizure risk, G for Granulocytopenia (agranulocytosis), H for Hypotension (orthostatic), T for Tachycardia (myocarditis)
  • QT Prolongation (Ziprasidone): Risk of abnormal heart rhythms like torsades de pointes.

Typical vs Atypical

  • Typical Antipsychotics tend to more strongly block dopamine, leading to higher risks of extrapyramidal symptoms (EPS).
  • Atypical Antipsychotics have greater effects on serotonin, which may reduce the risk of EPS but can still cause other side effects like weight gain and sedation.
  • Both classes share common side effects such as dry mouth, sleepiness, and weight gain.

Easy Way to Remember difference: Arjun Got CAP in PHD due to NARCOZ addiction

CAP & PHD → Typical (First-Generation) Antipsychotics

  • CAP = Chlorpromazine, Acepromazine, Promazine → Low-potency typical antipsychotics
  • PHD = Prochlorperazine, Haloperidol, Droperidol → High-potency typical antipsychotics

NARCOZ → Atypical (Second-Generation) Antipsychotics

  • Aripiprazole, Risperidone, Clozapine, Olanzapine, Ziprasidone

Read our article to learn more mnemonics for typical antipsychotics.

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