Antipsychotics Medications Practice Questions with Answers and NCLEX® Review

Introduction to Antipsychotics Medications

There are many types of antipsychotic medications available. Some are more commonly used than others, but all have their own unique side effects and benefits.

The two main types of antipsychotics are typical antipsychotics (also called first-generation or conventional) and atypical antipsychotics (also called second-generation).

Antipsychotics work by blocking receptors in the brain that receive dopamine, a neurotransmitter (chemical messenger) that transmits information between neurons (brain cells). This helps regulate certain chemicals in the brain that cause certain symptoms like delusions and hallucinations. 

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Typical vs Atypical Antipsychotics

Typical antipsychotics have been around for decades, while atypical antipsychotics have been developed more recently. Both are effective in treating serious psychiatric disorders but work differently inside the body and can have different side effects.

Atypical antipsychotics are a newer class of medication used to treat conditions like schizophrenia and bipolar disorder. These medications work by blocking the action of dopamine in the brain, which helps to reduce symptoms such as hallucinations and delusions.

Atypical antipsychotics have become increasingly popular over time due to their reduced risk for serious side effects (like stroke or seizures), compared with typical antipsychotics because they don’t block as many neurotransmitters in the brain. 

Typical antipsychotics are older medications that have been around longer, and were developed to treat schizophrenia and other psychotic disorders. They work by blocking dopamine receptors but also block other neurotransmitters like serotonin, norepinephrine, or acetylcholine.They tend to be less expensive than atypical antipsychotics, but they may cause more severe side effects, such as movement problems (e.g., stiffness or tremors). 

The main difference between the two types of antipsychotics is that the first-generation (typical) drugs block dopamine, and the second-generation drugs (atypical) block dopamine and affect serotonin levels. In addition, evidence suggests that some second-generation drugs have milder movement-related side effects than first-generation drugs.

Haloperidol

Haloperidol is a drug used to treat schizophrenia, bipolar disorder, and other mental illnesses. It’s a typical antipsychotic drug that blocks dopamine receptors in the brain. It can also be used to control psychotic episodes related to delirium, dementia, and mania.

This medication works differently than other antipsychotic medications by blocking dopamine receptors in the brain instead of serotonin receptors. 

Indication 

Haloperidol helps treat symptoms (especially controlling motor movement) of various conditions such as schizophrenia, acute psychosis, and Tourette syndrome.

Haloperidol Mechanism of Action 

Haloperidol blocks postsynaptic dopamine (D2) receptors in the brain’s mesolimbic system.

Side Effects 

• Inability to move the eyes
• Muscle spasms (especially of the neck and back)
• Difficulty speaking or swallowing
• Severe restlessness
• Shuffling-like walk.
• Stiffness of the arms and legs
• Loss of balance control

Clozapine

Clozapine is an atypical antipsychotic that blocks dopamine receptors and decreases dopamine activity in the brain. This lowers psychotic symptoms like hallucinations and delusions. 

Because it works by blocking receptors rather than stimulating them as other antipsychotics do, Clozapine has fewer side effects than other antipsychotics, including fewer seizures and less risk of hyperglycemia (high blood sugar).

Indication 

When combined with persistent suicidal or self-destructive conduct, schizophrenia and schizoaffective symptoms may be resistant to treatment with other antipsychotic medications.

Clozapine Mechanism of Action 

The blockage of D1-4 dopamine receptors, having the highest affinity for the D4 dopamine receptor, and 5-HT2A/5-HT2C serotonin receptors.

Side Effects

• Drowsiness
• Blurred vision
• Convulsions or seizures

Risperidone

Risperidone is an atypical antipsychotic drug that is used to treat mental disorders such as schizophrenia and bipolar disorder. It works by blocking dopamine receptors in the brain to reduce psychosis and other symptoms of mental illness.

Risperidone can also be used to treat irritability in children with autism and other developmental disorders.

Indication

The treatment for autistic disorder-related irritability, as well as schizophrenia and schizoaffective symptoms when not responding to other antipsychotics.

Risperidone Mechanism of Action 

Inhibiting the reuptake of serotonin and norepinephrine and the blockade of D2 receptors (specifically in the mesolimbic pathway).

Side Effects

• Aggressive behavior
• Difficulty concentrating
• Agitation or anxiety
• Blurred vision.
• Difficulty speaking or swallowing
• Inability to move the eyes
• Increased urine output

Ziprasidone Hydrochloride

Ziprasidone Hydrochloride is an atypical antipsychotic used to treat symptoms of schizophrenia,  bipolar disorder, and agitation associated with Alzheimer’s disease. It works by blocking certain receptors in your brain responsible for sending messages from one nerve cell to another. 

This drug blocks dopamine, serotonin, and histamine receptors to reduce psychotic-related symptoms.

Indication 

Treating symptoms of bipolar mania, acute psychosis, and agitation.

Ziprasidone Hydrochloride Mechanism of Action 

Binding to dopamine D2 and serotonin-2A (5-HT2A) receptors.

Side Effects 

• Cough
• Difficulty with speaking
• Inability to sit still
• Loss of balance control
• Muscle trembling, jerking, or stiffness
• Drooling

Antipsychotics Medications Conclusion

Antipsychotics are a class of drugs used to treat the signs and symptoms of mental illnesses like schizophrenia and bipolar disorder. Antipsychotic drugs come in a wide variety, though some are more frequently used than others. 

Dopamine is a neurotransmitter (chemical messenger) that transports information between neurons, and antipsychotics operate by inhibiting the receptors in the brain that receive it (brain cells). This assists in controlling specific brain chemicals that contribute to symptoms like hallucinations and delusions.

Atypical antipsychotics were created more recently than typical antipsychotics, which have been around for decades. Both medications perform well in the treatment of severe psychiatric diseases, although they have different physiological actions and potential adverse effects.

Both categories of drugs work equally well overall, although no drug or type of drug works equally well for every client who takes it.

Sources

https://www.ncbi.nlm.nih.gov/books/NBK519503/

https://pubmed.ncbi.nlm.nih.gov/15702141/