Antipsychotics - Featured articles

Antipsychotics News: Cariprazine, Risperidone and New Drug Applications

Author: Flavio Guzman, MD Editor Psychopharmacology Institute Dr. Guzman has no conflicts of interest to disclose. Cariprazine for Negative Symptoms of Schizophrenia: The FDA Refuses to Review Supplemental New Drug Application (sNDA) The FDA has refused Allergan’s request to review a Supplemental New Drug Application (sNDA) to expand the approved uses to include negative symptoms of schizophrenia…

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Long-Acting Injectable Antipsychotics: A Practical Guide for Prescribers

Author: Flavio Guzman, MD Competing interests: none This article summarizes the most clinically relevant features of long-acting injectable antipsychotics (LAIs, previously known as depot antipsychotics). We discuss general concepts as well as key prescribing facts of individual agents. The guide also includes two new formulations: aripiprazole lauroxil (Aristada) and 3-month paliperidone palmitate (Invega Trinza). Advantages and disadvantages of long-acting antipsychotics…

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Summary of Newly Approved Antipsychotics

By Flavio Guzman, MD Two new second-generation antipsychotics were approved in 2015: brexpiprazole (Rexulti) and cariprazine (Vraylar). Like aripiprazole (Abilify), they are both D2 partial agonists and are associated with risk of akathisia. Aripiprazole, brexpiprazole and cariprazine are FDA-approved for the treatment of schizophrenia. Aripiprazole and cariprazine are approved for the treatment of manic episodes in…

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Reviewing Antipsychotic Adverse Effects with Prof. Mark Taylor

Professor Mark Taylor is a consultant psychiatrist at the NHS in the UK. He is also Associate Professor at the University of Queensland in Brisbane Australia. He is the coauthor of a paper published in the Journal of Psychopharmacology: “First do no harm.” A systematic review of the prevalence and management of antipsychotic adverse effects”.…

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First-Generation Antipsychotics: An Introduction

Authors: Flavio Guzman, MD; Abimbola Farinde,PharmD First-generation antipsychotics (FGAs) are drugs used primarily for the treatment of schizophrenia and related psychotic disorders. Use of FGAs has declined in the last few years, mainly because of an increase in prescriptions of second-generation agents. Since FGAs are considerably less expensive than newer antipsychotics, they remain a valuable option…

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The Four Dopamine Pathways Relevant to Antipsychotics Pharmacology

By Flavio Guzmán, MD This video describes the 4 dopamine pathways relevant to the mechanism of action and adverse effects of antipsychotic drugs. Presentation outline: General overview of dopaminergic pathways Mesolimbic pathway & positive symptoms of schizophrenia Mesocortical pathway: negative & cognitive symptoms Nigrostriatal pathway & EPS Tuberoinfundibular pathway & prolactin release Summary Transcript Introduction…

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Neurological side effects of antipsychotics: akathisia, dystonia and parkinsonism

This video summarizes acute neurological side effects of antipsychotics: akathisia, dystonia and parkinsonism. 1. Akathisia and Dystonia A classification of neurological side effects Akathisia ( Clinical features, a clinical video, medications that can cause akathisia and management) Acute dystonia (Clinical features, pathophysiology, management) 2. Parkinsonism Clinical features Mechanism of EPS Differences between antipsychotic induced parkinsonism and Parkinson’s…

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Mechanism of Action of Antipsychotic Agents

Author: Flavio Guzman, MD This video discusses the following topics: The dopamine hypothesis of schizophrenia (the evidence that supports it and its limitations). First-generation (typical) antipsychotics are D2 antagonists. Pharmacodynamic profile of second-generation antipsychotics (5-HT2A antagonism, fast D2 dissociation, 5-HT1A agonism). The main differences between first and second generation antipsychotics (from a receptor binding perspective).…

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