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Antipsychotic drugs - Coggle Diagram

- - - - Acute muscular dystonia – linguo-facial, initial, 2%
        
        Parkinsonism (rigidity, tremor, bradykinesia) – in 1-4 weeks
        
        Rabbit syndrome – after several years – perioral tremors
        
        Treat with central anticholinergics – Benztropine, Biperiden, Trihexyphenydyl
      - Akathisia - 20%, 1-8 weeks
        
        treated with Propranolol/ benzodiazepines
      - EPS more with 1st gen, less with atypical antipsychotics
        
        Max with haloperidol
        
        maximum incidence among atypical – risperidone high dose
      - Tardive Dyskinesia
        
        After months to years (20-40%)
        
        Involuntary movements, including bilateral and facial jaw movements and “fly-catching” motions of the tongue
        
        irreversible in many
        
        Anticholinergics (including TCADs, etc) can worsen the condition
        
        Switch to atypical antipsychotic
        
        Treatment - Diazepam
        Valbenazine, Deutetrabenazine – inhibit VMAT
      - Malignant Neuroleptic Syndrome
        muscle rigidity, fever, leukocytosis, altered mental status and stupor, unstable BP & HR, diaphoresis, myoglobinemia, ↑CK
        
        Treatment – discontinue drug, supportive therapy – external cooling, central anticholinergics, Dantrolene / Bromocriptine
        
        Switch to atypical drug after recovery