Atypical Antipsychotics

Front 1

Aripiprazole

Back 1

Partial Agonist D2 receptors, 5HT-1, 5HT-2 (antagonist), H1, alpha-1

Dosage: 10-30 mg

SE's: headache, nausea, vomiting, insomnia, tremor, and constipation
- Lower rates of EPS, lipid or prolactin increases, and sedation

Front 2

Clozapine

Back 2

Dosage: Initial 25-50 mg; daily 150-600 mg

SE's: prominent and persistent; agranulocytosis (monitor WBC), orthostatic hypotension, tachycardia, weight gain, metabolic syndrome, sedation, constipation
- Seizure, myocarditis, and PE
- LOWER rates of EPS and tardive dyskinesia

Front 3

Risperidone

Back 3

Dosage: Initial - 1-2 mg; daily 2-6 mg

SE's: increased risk of pituitary adenomas and EPS (similar to mid-level first generation)

Front 4

Quetiapine

Back 4

Dosage: Initial - 50 mg; daily 300-750 mg

SE's: strong histaminic, cholinergic, and alpha-1-adrenergic binding, responsible for relatively high levels of sedation, anticholinergic effects, and orthostatic hypotension
- QT prolongation

Front 5

Olanzapine

Back 5

Dosage: Initial - 5-10 mg; daily 10-30 mg
* effective dose is lowered by cigarette smoking

SE's: significant activity at histaminic and muscarinic receptors; potential cardio risks; Weight gain, hyperglycemia, and hyperlipidemia are greater with olanzapine than with other (esp in adolescents)

Front 6

Ziprasidone

Back 6

Dosage: Initial - 40-80 mg; Daily 120-160 mg

SE's: low histaminic and no appreciable muscarinic activity; QT elongation (esp w/ other such drugs); cause less weight gain, hyperglycemia, and hyperlipidemia than other second-generation antipsychotics

Front 7

Atypicals for Acute Agitation

Back 7

Aripriprazole (IM, PO - disintegrating/oral solution) - 9.75 q2 / 10-15 q2
Olanzapine (IM, PO - disintegrating) - 5-10 q2-4 / 5-10 q.5-2
Resperidone (Disintegrating/oral solution) - 1-2 q.5-2
Ziprasidone (injection) - 10-20 q2-4