Antipsychotic agents and lithium

Are lipid soluble and readily enter CNS

Atypical antipsychotics

Clozapine

No affinity for D2 receptor, and one of the only drugs with affinity for D4

Lithium

Decrease in blood levels can be due to caffeine or theophylline

Increase in blood levels can be due to dehydration, ACEIs, nsaids or diuretics

Haloperidol

Only one that doesn't have any H1 activity

Molindone

Indication: tourettes, rarely schizo

Reversal of parkinson-like syndrome

Muscarinic blocking agents, like diphenhydramine

Thioridazine

Strongest autonomic effects

Weakest autonomic effects

Phenothiazines

Olanzapine

Weight gain, hyperglycemia

Aripiprazole

Least sedating of newer agents

No propensity for weight gain or endocrine effects

Severe conduction defects and can lead to fatal arrhythmia

Can be appropriate treatment for phencyclidine intoxication

Most atypicals especially Ziprazidone and quetiapine prolong QTinterval

can treat failure to ejaculate

Sedation and orthostatic hypotension are side effects

drug of choice in delirium and tourettes

D2 partial agonist

Risperidone

EPS risks are highest with this atypical antipsychotic