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Psychiatric disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Typical antipsychotic drugs have a larger amount of reproductive safety data available, especially haloperidol. The high-potency antipsychotics (e.g., haloperidol) are preferable to the low-potency drugs. Several of the typical antipsychotics (chlorpromazine, haloperidol) have been previously prescribed during pregnancy for hyperemesis with safety data in pregnancy obtained in these studies (144,145).
Antipsychotics: pharmacology
Published in Kathy J Aitchison, Karena Meehan, Robin M Murray, First Episode Psychosis, 2021
Kathy J Aitchison, Karena Meehan, Robin M Murray
The first drug to be prescribed for the treatment of psychosis was chlorpromazine.110 Over the ensuing 35 years, many other drugs of similar pharmacological profile followed; these are termed ‘conventional’ or ‘typical’ antipsychotics. However, in the early 1990s the situation changed with the marketing of clozapine in most Western nations as the first antipsychotic with a significantly different profile, both in animal and human studies. It was termed an ‘atypical’ antipsychotic, on the basis of a lower potential to induce extrapyramidal side-effects.111 Since then other, similar antipsychotics have been synthesized, and although there is some difference of opinion as to what constitutes the definition of an atypical antipsychotic, it is generally agreed that they fulfil the criteria given in Table 5.112
Patients with Mental Disorder Under Home Restraint: Progress and Challenge of Release
Published in Teuku Tahlil, Hajjul Kamil, Asniar, Marthoenis, Challenges in Nursing Education and Research, 2020
Apart from human resource issue, mental health services in Aceh sometimes must deal with the inadequate supply of drugs, especially some types of antipsychotics. Although the national health insurance covers the mental health treatments, only the first generations or typical antipsychotics were available at the health post. The second generation or atypical antipsychotics must be obtained in a psychiatric hospital or in a General Hospital with mental health services. Patients who have used atypical antipsychotics during hospitalization then reluctantly do take the typical antipsychotics. This problem also leads to low adherence, relapse and re-restraint.
Risks and benefits of current and novel drugs to treat agitation in Alzheimer’s disease
Published in Expert Opinion on Drug Safety, 2022
Nathan Herrmann, Hui Jue Wang, Bing Xin Song, Kritleen K. Bawa, Krista L. Lanctôt
Recently, Mühlbauer et al. conducted a meta-analysis to present the most updated evidence on the efficacy and safety of antipsychotics for the treatment of agitation in people with dementia [21]. In line with findings published almost two decades earlier [26], there was very low-certainty evidence that typical antipsychotics improve agitation compared to placebo. In contrast, the review revealed moderate- and high-certainty evidence that typical antipsychotics increase the risk of drowsiness and extrapyramidal symptoms (EPS), respectively. This imbalance is further magnified when taking into consideration that many of the studies on typical antipsychotics are older and were conducted with less stringent methodologies. Adverse events (AEs) were not always carefully documented and there was a tendency to use high doses, resulting in an overestimation of benefits. There was better evidence on the efficacy of atypical antipsychotics, which generally have moderate benefits for agitation. However, much like their typical counterparts, use of atypical antipsychotics was found to increase the risks of various AEs. There was high-certainty evidence that atypical antipsychotics increase the risk of somnolence and moderate-certainty evidence that they increase extrapyramidal symptoms, serious adverse events (SAEs), and mortality. Overall, the results of that meta-analysis indicate that antipsychotics offer limited to modest effects for alleviating agitation, which may not be enough to justify the safety concerns associated with their use in the majority of patients.
An update on medication management of women with schizophrenia in pregnancy
Published in Expert Opinion on Pharmacotherapy, 2019
Carolyn Breadon, Jayashri Kulkarni
One study has suggested that the most consistent predictor of large for gestational age babies is the pre-pregnancy weight of the mother [30]. Boden et al. [53] found that macrocephaly may be increased in babies of mothers taking olanzapine and clozapine. Another study using placental cord blood to measure drug exposure has suggested that haloperidol may be associated with large for gestational age babies [43]. Newham et al. [45] have shown a greatly increased rate of large for gestational age babies born to women taking atypical antipsychotic medications in pregnancy (20% in this group, compared with 2% in those exposed to typical antipsychotics and 3% in the reference unexposed group). This effect was especially large in babies exposed to olanzapine and clozapine, of whom 31% were large for gestational age (>90th centile).
Formulation and biopharmaceutical evaluation of risperidone-loaded chitosan nanoparticles for intranasal delivery
Published in Drug Development and Industrial Pharmacy, 2019
Rajalakshmi Rukmangathen, Indira Muzib Yallamalli, Prasanna Raju Yalavarthi
Schizophrenia is a chronic mental ill health, characterized by an array of indications like delusions, hallucinations, disorganized speech or behavior, and impaired cognition. About 0.7% of global urban population is seriously tormented with schizophrenia, as treatment choices are limited [1]. Atypical or second-generation antipsychotics are front-line agents in the pharmacotherapy of schizophrenia owing to low side effects, substantive efficacy, and relative safety over conventional/typical antipsychotics. Amisulpride, aripiprazole, asenapine, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone (RS), and ziprasidone are the currently available promising atypical antipsychotics [2].