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ANTIPSYCHOTICS Psychotropic drugs are those having primary effects on Psyche (mental processes) and are used for treatment Of Psychiatric disorders. One of the primary psychotic disorders in which the Antipsychotics works is the, Psychosis

Psychosis: : 

Psychosis: These are severe psychiatric Illness with serious distortion of thought, behavior, capacity to recognize reality and of perception (delusions and hallucinations). Psychosis can be broadly Categorized in to four groups:

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Acute and chronic organic brain syndromes (cognitive disorders) such as, Delirium and dementia, prominent features of confusion, disorientation, defective memory and disorganized behavior. Functional disorders such as, memory and orientation mostly retained by emotion, thought, reasoning and behavior are altered. Schizophrenia (split mind) i.e. splitting of perception and interpretation from reality- hallucination, inability to think coherently. Schizophrenia is often described in terms of positive or negetive (deficit) symptoms.. Paranoid state i.e. fixed delusions (false beliefs) and loss of insight in to abnormality.

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Antipsychotic drugs are also known as Neuroleptics, Ataractic, Major Tranquilizer and Anti- Schizophrenic drugs. A first generation of antipsychotics, known as Typical antipsychotics, was discovered in the 1950s. Most of the drugs in the second generation, known as Atypical antipsychotics, have been developed more recently.

Classification: : 

Classification: Typical Antipsychotics: 1.Phenothiazines: a. Aliphatic side chain: Chlorpromazine, Triflupromazine b. Piperidine side chain: Thioridazine c. Piperazine side chain: Trifluoperazine, Fluphenazine   2.Butyrophenones: Haloperidol, Trifluperidol, Penfluridol   3.Thioxanthenes: Flupenthixol     4. Other heterocyclics: Pimozide, Loxapine   B. Atypical neuroleptics: Clozapine, Risperidone, Olanzapine, Quetiapine, Aripiprazole, Ziprasidone.

Mechanism of Action: : 

Mechanism of Action: -Antipsychotic blocks D₂ receptors in the brain's Dopaminergic pathway. -Some also block or partially block serotonin receptors (particularly 5HT2A, C and 5HT1A receptors)   -But antipsychotic drugs can also block wide range of receptor targets.

Dopaminergic pathway in Brain: : 

Dopaminergic pathway in Brain: Mesolimbic- mesocortical: Control behavior, cognitive funtion regulated by D₂ Receptor. Nigrostriatal: Control Voluntary Movement regulated by D₁ and D₂ receptor. Tuberoinfundibular: Control prolactin secretion Regulated by D₂ receptor.

In the Mesolimbic- Mesocortical and Nigrostriatal pathway Antipsychotic blocks: : 

In the Mesolimbic- Mesocortical and Nigrostriatal pathway Antipsychotic blocks:

In the Tuberoinfundibular pathway Antipsychotics block: : 

In the Tuberoinfundibular pathway Antipsychotics block: Dopamine released at this site regulates the secretion of prolactin from anterior the pituitary gland. Antipsychotics blocks D₂ receptor at this site.

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Antipsychotic blocks D₂ receptors Some also block or partially block serotonin receptors

Pharmacology of Antipsychotics:Typical Antipsychotics : 

Pharmacology of Antipsychotics:Typical Antipsychotics

Atypical Antisychotic drugs : 

Atypical Antisychotic drugs These are newer 2nd Generation antipsychotics that have weak D₂ receptor blocking but potent 5-HT₂ antagonistic activity. They May improve the impaired Cognitive function in psychotics.

Adverse effects: : 

Adverse effects: On CNS: - Drowsiness - lethargy - mental confusion - seizure. CVS: - Postural hypotension - palpitation - arrythmia in elderly Anticholinergic: - Dry mouth - blurring of vision - constipation - urinary inconsistency

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Endocrine: - Hyperprolactinemia - amenorrhoea - infertility - gelactorrhoea and gynaecomastia. Extrapyramidal disorders: - Parkinsonism - Acute muscular dystonias - Akathisia - Malignant Neuroleptic Syndrome - Tardive dyskinesia Miscellaneous: - Weight gain - Blood sugar – lipid rise - worsening of diabetes.

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Thank You

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