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
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.
- 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.
