Atypical Antipsychotics Overview and Mnemonics

Sep 25, 2024

Atypical Antipsychotics Lecture Notes

Overview

  • Purpose: Used to treat psychosis (schizophrenia, other psychotic disorders) and as mood stabilizers in bipolar disorder.
  • Challenge: Names do not share a common ending, making memorization difficult.

Mnemonics and Symbols

  • Setting: Surprise party in an art enthusiast's apartment with "The Scream" painting symbolizing psychosis.
  • Clozapine: Closet as a symbol - "Closet for Clozapine."
  • Olanzapine: Lance from the costume closet - "Lance for Olanzapine."
  • Aripiprazole: AirPods - "Aripiprazole AirPods."
  • Risperidone: Whispering - "Whisperadone."
  • Quetiapine: Shushing for quiet - "Quiet for Quetiapine."
  • Ziprasidone: Zipper on a purse - "Ziperazidone."

Clinical Uses

  • Psychosis Treatment: Effective for schizophrenia by treating both positive (hallucinations, delusions) and negative (flat affect, antisocial behavior) symptoms.
  • Bipolar Disorder: Mood-stabilizing effects (e.g., Risperidone).
  • Additional Uses: Can be used in postpartum psychosis, dementia-related psychosis.

Side Effects

  • Extrapyramidal Symptoms (EPS): Movement disorders with tremors, muscle spasms, restlessness.
    • Examples: Tardive dyskinesia, dystonia, akathisia.
  • Metabolic Syndrome: Weight gain, insulin resistance, high blood sugar.
  • Sedation: Drowsiness, advised to avoid other sedatives like benzodiazepines and alcohol.
  • Anticholinergic Effects: Dry mouth, blurry vision, urinary retention.
    • Mnemonic: Anticholinergic effects = blocked parasympathetic system.
  • Agranulocytosis: Specific to Clozapine; decreased white blood cells, risks for infections.
    • Mnemonic: Spilled granola for agranulocytosis.
  • Neuroleptic Malignant Syndrome (NMS): Muscle rigidity, fever, altered mental status.
    • Mnemonic: Lead pipe for lead pipe rigidity.
  • QT Prolongation and Torsade de Pointe: Specific to Ziprasidone; requires cardiac monitoring.
    • Mnemonic: Twisted streamers for Torsade de Pointe pattern.

Summary

  • Drug Names: Clozapine, Olanzapine, Aripiprazole, Risperidone, Quetiapine, Ziprasidone.
  • Main Uses: Psychosis, schizophrenia, bipolar disorder.
  • Key Side Effects: EPS, metabolic syndrome, sedation, NMS, agranulocytosis (Clozapine), QT prolongation (Ziprasidone).

Reminder: Be vigilant for signs of NMS and agranulocytosis due to their severe implications. Consider periodic cardiac monitoring for patients on Ziprasidone.

Additional Resources

  • Further Study: Review topics like EPS specifics, anticholinergic effects, and side effect management.
  • Interactive Tools: Check out fact lists and review images for deeper understanding.