Table of Contents
Memorize Typical Antipsychotic drugs, also known as First-Generation Antipsychotics (FGAs), using the following mnemonic:
Drug Names:"High Flyers Chew Thorns"
- H: Haloperidol (High potency, treats schizophrenia, high EPS risk)
- F: Fluphenazine (High potency, available in long-acting injectable form)
- C: Chlorpromazine (Low potency, causes sedation & orthostatic hypotension)
- T: Thioridazine (Low potency, QT prolongation, retinal deposits)
Mechanism: "Mad Nerds Teach Campers Logic"
- M: Mesolimbic - Reduces dopamine in this pathway, improving psychosis (delusions, hallucinations)
- N: Nigrostriatal - Causes motor side effects (EPS, Parkinsonism)
- T: Tuberoinfundibular - Increases prolactin levels, causing hyperprolactinemia
- C: cAMP Increases - Blocking D2 receptors raises cAMP levels
- L: Lipid-soluble - Allows prolonged effects due to storage in fat
MOA: D2 receptor antagonism blocks dopamine’s effects, impacting the several brain pathways mentioned above.
Clinical Use / Indications: "Silly Men Fight Panic, Hasty Humans Disrupt"
- S: Schizophrenia - Treats positive symptoms (delusions, hallucinations), but not effective for negative symptoms (flat affect, minimal speech)
- M: Mania with Psychosis - Treats Bipolar Type I during manic episodes with psychotic symptoms
- F: Psychotic Episodes in Pregnancy - Preferred over atypical antipsychotics for pregnant women.
- P: Psychotic Agitation - Haloperidol used for delirium, agitation due to delusions or substance use.
- H: Huntington's Disease - Reduces involuntary movements by inhibiting dopamine in basal ganglia.
- H: High Potency in Tourette's - High-potency antipsychotics (Haloperidol, Fluphenazine, Pimozide) for treatment-resistant tics.
- D: Disruptive Mood Dysregulation Disorder - Used to treat severe mood issues in children (e.g., irritability).
Adverse Side Effects
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1. Neuroleptic Malignant Syndrome (NMS): "FAMU"
- F = Fever
- A = Altered mental status
- M = Muscle rigidity
- U = Unstable vitals
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2. Extrapyramidal Symptoms (EPS): "The 3 A's & P"
- A = Acute Dystonia: Muscle spasm/stiffness (e.g., twisted neck)
- A = Akathisia: Restlessness, urge to move.
- A = Parkinsonism: Tremors, rigidity, bradykinesia
- P = Tardive Dyskinesia: Involuntary movements (e.g., lip smacking)
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3. Hyperprolactinemia: "GALS"
- G = Galactorrhea
- A = Amenorrhea (or oligomenorrhea)
- L = Low libido
- S = Sexual dysfunction (e.g., impotence)
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4. Anticholinergic Effects: "Can't See, Can't Pee, Can't Spit, Can't Shit"
- Can't See = Blurred vision (mydriasis)
- Can't Pee = Urinary retention
- Can't Spit = Dry mouth
- Can't Shit = Constipation
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5. Sedation (Antihistaminic Effects): "Drowsy Dog"
- D = Drowsiness
- D = Decreased alertness/sedation
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6. Orthostatic Hypotension: "Alpha Blocker Blues"
- Alpha = Blockade of alpha-1 adrenergic receptors
- Blues = Hypotension when standing
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7. Metabolic Syndrome: "Whales Dead Heavy"
- W = Weight gain
- D = Dyslipidemia
- H = Hyperglycemia
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8. Ocular Deposits: "C for Cornea and T for Retina"
- C = Chlorpromazine: Corneal deposits
- T = Thioridazine: Retinal deposits
Read our article to learn more mnemonics for atypical antipsychotics.