antipsychotic

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antipsychotic

 [an″te-, an″ti-si-kot´ik]
modifying psychotic behavior.
antipsychotic agent any drug that favorably modifies psychotic symptoms; categories include the phenothiazines, butyrophenones, thioxanthenes, dibenzodiazepines, diphenylbutylpiperidines, dihydroindolones, and dibenzoxazepines. They are chemically diverse but pharmacologically similar. Formerly called major tranquilizer.

Antipsychotics stabilize mood and reduce anxiety, tension, and hyperactivity. They are also effective in helping to control agitation and aggressiveness. Delusions and hallucinations are often modified and may be eliminated by such an agent, but once the drug is discontinued, the delusions and hallucinations often return within a short while. Different antipsychotic agents bind to dopamine, histamine, muscarinic, cholinergic, α-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for the major antipsychotic, antiemetic effects of these agents as well as neurologic side effects. The drugs are contraindicated in patients suffering from central nervous system depression, severe allergy, Parkinson's disease, or a blood dyscrasia. There also is the possibility of drug-drug interaction when neuroleptic drugs are given concurrently with barbiturates, alcohol, tricyclic antidepressants, antihypertensives, meperidine, anticonvulsants, or levodopa.

Many antipsychotics have alarming side effects (see extrapyramidal effects); thus there must be thorough patient education and individualized adjustments in dosage. The side effects can usually be minimized by gradually increasing the dosage until the optimum for the individual is reached. Side effects such as a discomforting restlessness and agitation (akathisia), involuntary rhythmic movements of the trunk and limbs, parkinsonism, and tardive dyskinesia are often misinterpreted as symptoms of some unrelated disorder; these are often the reason for noncompliance or stopping of medication by patients. Approximately 20 per cent of the patients treated with neuroleptics for long periods develop tardive dyskinesia, a syndrome of choreoathetoid movements of the tongue, mouth, face, neck, limbs, and trunk, which may continue after the drug is stopped.

Antipsychotic agents are sometimes prescribed for conditions other than mental disorders. They can be beneficial in the control of nausea, in the treatment of intractable hiccups, in controlling the movement disorders associated with Huntington's chorea and Gilles de la Tourette's syndrome, and, in combination with other drugs, for the control of pain.

an·ti·psy·chot·ic

(an'tē-sī-kot'ik),
1. Synonym(s): antipsychotic agent
2. Denoting the actions of such an agent (for example, chlorpromazine).

antipsychotic

/an·ti·psy·chot·ic/ (-si-kot´ik) effective in the treatment of psychotic disorders; also, an agent that so acts. Antipsychotics are a chemically diverse but pharmacologically similar class of drugs; besides psychotic disorders, some are also used to treat movement disorders, intractable hiccups, or severe nausea and vomiting.

antipsychotic

(ăn′tē-sī-kŏt′ĭk, ăn′tī-)
adj.
Counteracting or diminishing the symptoms of psychotic disorders, such as schizophrenia.
n.
An antipsychotic drug.

antipsychotic

[-sīkot′ik]
Etymology: Gk, anti + psyche, mind, osis, condition
1 pertaining to a substance or procedure that counteracts or diminishes symptoms of a psychosis.
2 an antipsychotic drug. Categories include the phenothiazine derivatives, butyrophenones, thioxanthene derivatives, dibenzodiazepines, diphenylbutylpiperidines, dihydroindolones, and dibenzoxazepines. They are chemically diverse but pharmacologically similar. Formerly called major tranquilizer.

antipsychotic

adjective Referring to an antipsychotic drug.

noun Any drug that attenuates psychotic episodes.
 
Agents
Phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, diphenylbutylpiperidines.
 
Main types of antipsychotics
Typical and atypical, which differ in their side/adverse effects.
 
Indications
Management of schizophrenic, paranoid, schizo-affective and other psychotic disorders; acute delirium, dementia, manic episodes (during induction of lithium therapy), control of movement disorders (in Huntington’s disease), Tourette syndrome, ballismus, intractable hiccups, severe nausea and vomiting (by blocking the medulla’s chemoreceptor trigger zone).
 
Adverse effects
Extrapyramidal effects (dystonia, akathisia, parkinsonism), tardive dyskinesia due to blocking of basal ganglia; sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are due to blocking of histaminic, cholinergic and adrenergic receptors.

an·ti·psy·chot·ic

(an'tē-sī-kot'ik)
1. Synonym(s): antipsychotic agent.
2. Denoting the actions of such an agent.

antipsychotic

A drug used in the treatment or control of severe mental illness such as SCHIZOPHRENIA. The antipsychotic drugs include such groups as the benzamides (Amisulpride, Dolmatil, Solian); benzisoxzoles (Risperidal); butyrophenones (Anquil, Dozic, Droleptan, Haldol, Serenace); phenothiazines (Fentazin, Largactil, Melleril, Modecate, Moditen, Neulactil, Nozinan, Stelazine); and thioxanthines (Clopixol, Depixol).

an·ti·psy·chot·ic

(an'tē-sī-kot'ik)
1. Synonym(s): antipsychotic agent.
2. Denoting the actions of such an agent (e.g., chlorpromazine).

antipsychotic

effective in the management of manifestations of psychotic disorders; also, an agent that so acts. There are several classes of antipsychotic drugs (phenothiazines, thioxanthenes, dibenzazepines and butyrophenones), all of which may act by the same mechanism, i.e. blockade of dopaminergic receptors in the central nervous system. Called also neuroleptic and major tranquilizer.
References in periodicals archive ?
Table 7 Conventional Versus Second-Generation Antipsychotic Use Over Time, by Race: Ambulatory Restart Patients with Schizophrenia Initial Drug Used White Black Other Percent Closed Access Period (1) Conventional Antipsychotic 70.
Until very recently, only conventional antipsychotic drugs had been approved for intramuscular injection, and as a result these were the only drugs available for involuntary administration.
All the 13 patients showed very good response with very low doses of conventional antipsychotic tab chlorpromazine within two weeks.
Labeling for conventional antipsychotics will now contain warnings about an increased risk of death among elderly users with dementia-related psychosis, according to new requirements issued by the Food and Drug Administration.
The incidence of tardive dyskinesia with recent exposure to atypical antipsychotics alone was more similar to that for conventional antipsychotics than in most previous studies.
Major Finding: After 2003, rates of conventional antipsychotic use among outpatients with dementia were less than 2%.
The older, conventional antipsychotic drugs have been most commonly associated with DIP.
In a study published in the January 2002 issue of The New England Journal of Medicine, Risperdal was found to be significantly more effective in reducing the risk of relapse than haloperidol, a conventional antipsychotic long considered the "gold standard" in treatment of psychosis.
Rather than emphasizing that the conventional antipsychotic perphenazine (brand name: Trilafon) showed results comparable with those of four newer antipsychotics in CATIE, professionals should be concerned that 74% of patients who received at least one dose of one of the studied drugs discontinued treatment prematurely, says the chairman of the University of Maryland School of Medicine's psychiatry department.
In a study published in a January issue of The New England Journal of Medicine, Risperdal was found to be significantly more effective in reducing the risk of relapse than haloperidol, a conventional antipsychotic long considered the "gold standard" in treatment of psychosis.
For conventional antipsychotics, the major decline in use came in the 1990s with the introduction of atypical antipsychotics; after 2003, rates of conventional antipsychotic use among outpatients with dementia were less than 2%.
There rate of sudden cardiac death was twice as high among current users of conventional antipsychotic drugs as it was among nonusers (incidence-rate ratio, 1.

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