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Drugs Affecting the Central Nervous System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: It should be used with caution because the pregnancy experience in humans is limited, and the reproduction studies in animals have shown the risk of embryo-fetal toxicity associated with the use of Ziprasidone.
Psychopharmacology EMIs
Published in Michael Reilly, Bangaru Raju, Extended Matching Items for the MRCPsych Part 1, 2018
Clozapine.Droperidol.Flupenthixol.Olanzapine.Pimozide.Quetiapine.Risperidone.Sulpiride.Trifluoperazine.Ziprasidone.
The Psychiatric Interview
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Thioridazine, and mesoridazine, are no longer available in most countries, and pimozide should be avoided in patients with known heart disease. Ziprasidone should be used cautiously in patients with heart disease, with baseline and follow-up ECG recommended. However, it does not require special monitoring in non-cardiac patients.
Does the gut microbiome mediate antipsychotic-induced metabolic side effects in schizophrenia?
Published in Expert Opinion on Drug Safety, 2022
Svetlina S. Vasileva, Jack Tucker, Dan Siskind, Darryl Eyles
The mechanisms for SGA-induced metabolic side effects are still unclear. Just as the receptor affinities differ between different SGAs, accordingly, so too does the severity and extent of the side-effect profile. Olanzapine, clozapine and quetiapine consistently show the most significant metabolic side-effects, with weight gain and risk for development of T2DM being greater than that demonstrated by other SGAs [13,33–36]. On the other hand, while ziprasidone has no significant impact on weight gain, it is associated with increased risk of T2DM [37]. There is evidence to suggest that weight gain and glucose dysregulation are mediated in part by SGAs impact on glucagon-like peptide-1 (GLP-1) [38]. Other potential pathways include blockade of hypothalamic H1 receptors [39] and serotonin receptor 5-HT2C [40,41] interfering with central satiety and appetite centers. The blockade of D2 receptors may also interfere with normal reward-related behaviors [42]. Importantly, it has been well established that female and pediatric populations demonstrate increased susceptibility to the metabolic side-effects of SGAs [43].
Safety and tolerability of antipsychotic agents in neurodevelopmental disorders: a systematic review
Published in Expert Opinion on Drug Safety, 2020
Felice Iasevoli, Annarita Barone, Elisabetta Filomena Buonaguro, Licia Vellucci, Andrea de Bartolomeis
Overall, both aripiprazole and risperidone appear safe and tolerable. However, aripiprazole may represent a better tolerable agent in many respects and may be considered the first-line antipsychotic, with risperidone as the second line. Olanzapine and paliperidone should be used when both aripiprazole and risperidone are ineffective or should be avoided for untoward side effects. Data on haloperidol, lurasidone, and ziprasidone are currently inconclusive. Ziprasidone has been studied in small populations but appears a promising agent to prevent detrimental metabolic effects. However, the potential for neurological and cardiological side effects should be bore in mind. Haloperidol use should be discouraged due to the risk of treatment-emergent and treatment-withdrawal motor side effects. Notably, ASD is frequently comorbid with ID. Although available data did not allow to draw firm conclusions, the possibility that adverse events from antipsychotics may vary in ASD patients as a consequence of suffering from comorbid ID or not should be taken into account.
Two cases of priapism associated with Quetiapine
Published in Psychiatry and Clinical Psychopharmacology, 2018
Özge Şahmelikoğlu Onur, Hatice Kızılkale, Hüseyin Yumrukçal, Meltem Gürü
Various drugs have been implicated in priapism. Antipsychotic medications have varying affinities for adrenergic receptors. Although being rare, priapism is a well-known side effect that occurs with first generation antipsychotics; a few cases have also been reported with second generation antipsychotics. Ziprasidone and risperidone have the highest affinity, followed by clozapine and quetiapine for adrenergic receptors [4]. Priapism is attributed to the blockade of alpha-1 adrenergic receptors in corpus cavernosum. This side effect was previously thought to be associated with the use of typical antipsychotics, notably, thioridazine. Atypical antipsychotics, due to their favourable side effect profiles, are being prescribed ever more often and are considered to cause priapism infrequently. However, this side effect has been reported in patients taking ziprasidone, risperidone, clozapine, quetiapine, aripiprazole and olanzapine. The affinity of these drugs to alpha-1 adrenergic receptors vary significantly; affinity of quetiapine, compared to other antipsychotics is intermediate [5].