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Antipsychotic drugs extrapyramidal motor side effects - Coggle Diagram
Antipsychotic drugs extrapyramidal motor side effects
First gen / typical antipsychotic drugs
D2 receptor antagonists with antipsychotic potency
Chlorpromazine D2 receptor antagonist
Mechanism process
In schizophrenia dopamine activity is
hyperactive in nucleus accumbens of mesolimbic pathway.
is normal
When dopamine antagonists are administered to schizophreniacs, dopamine activity is
Returned to normal in nucleus accumbens of mesolimbic system.
Hypoactive in striatum of nigrostriatal pathway.
D2 receptor antagonists don't have high specificity to mesolimbic pathway but affects nigrostriatal pathway as well
Extrapyramidal motor system
Mediated through basal ganglia circuits
Second generation / atypical antipsychotic drugs
Clozapine
Limited treatment of negative and cognitive symptoms.
High toxicity to lymphocytes, leading to leukopenia
Adds to financial cost
Fatal so clozapine used as last resort
Excess salivation
hyperthermia
Olanzapine
Reduced EPS
Not effective in all patients
Variable effect
Slow effect, 6-10 weeks
First resort before typical antipsychotics for violent patients needing rapid onset of drug.
Still limited effectiveness to negative and cognitive symptoms.
Dual action on both D2 and 5HT-2A serotonin receptors
No understanding of why dual action has the effect
Physiological therapies
CBT
Ineffective to acute symptomatic patients
Hard against acutely symptomatic patients who are uncompliant
Usually used after initial stabilisation with drugs
Family therapy + control of environmental conditions
Identify genetic predisposition on frontal lobe.