scholarly journals AN OBSERVATIONAL COMPARATIVE STUDY OF EXTRAPYRAMIDAL SIDE EFFECTS IN PATIENTS TAKING TYPICAL AND ATYPICAL ANTIPSYCHOTICS

2021 ◽  
pp. 50-51
Author(s):  
Ankit Halder ◽  
Navna Panchami ◽  
Abhishek Das

Due to less extrapyramidal side-effects ,atypical antipsychotics use in psychiatry has increased a lot. But it is associated with other metabolic and endocrine side effects. Olanzapine is one such antipsychotic that less likely to cause hyperprolactinemia which can present as amenorrhea in patients.Here we present a rare case of olanzapine induced amenorrhoea reversed by switching to Aripiprazole.


1999 ◽  
Vol 174 (S38) ◽  
pp. 52-58 ◽  
Author(s):  
C. M. E. Stephenson ◽  
L. S. Pilowsky

The development of atypical antipsychotics has revolutionised the treatment of schizophrenia, as well as providing new insights into its cause. The archetypal atypical antipsychotic is clozapine, which has therapeutic advantages over traditional antipsychotics, as well as a low potential for producing extrapyramidal side-effects (EPS) (Kane et al, 1988). However, clozapine causes agranulocytosis in 1% of patients, and there has consequently been a search for novel atypical antipsychotics, as efficacious as clozapine, but without the need for intensive blood monitoring. There has been much discussion of the definition and characteristics of an atypical antipsychotic drug, and an operational understanding seems to have been agreed upon, that atypical drugs have therapeutic efficacy in treating schizophrenia, without producing EPS (Deutch et al, 1991; Kerwin, 1994).


1998 ◽  
Vol 13 (S1) ◽  
pp. 5s-8s
Author(s):  
GP Reynolds

SummaryRecent advances in antipsychotic treatment of schizophrenia have offered several new compounds which avoid many of the limitations of the classical antipsychotics. These so-called ‘atypical’ antipsychotics have fewer extrapyramidal side effects, greater efficacy against negative symptoms and greater efficacy in otherwise treatment-resistant patients. However, the mechanism of action of these atypical antipsychotics is still unclear. The several receptors currently implicated in the pharmacological profile of these atypical antipsychotics include subtypes of those for dopamine, serotonin, noradrenaline, and acetylcholine among others. The current hypotheses for possible mechanisms of action of atypical antipsychotics are discussed along with the experimental correlates of antipsychotic efficacy in animal models.


2010 ◽  
Vol 196 (6) ◽  
pp. 434-439 ◽  
Author(s):  
Nicolas A. Crossley ◽  
Miguel Constante ◽  
Philip McGuire ◽  
Paddy Power

BackgroundThere is an ongoing debate about the use of atypical antipsychotics as a first-line treatment for first-episode psychosis.AimsTo examine the evidence base for this recommendation.MethodMeta-analyses of randomised controlled trials in the early phase of psychosis, looking at long-term discontinuation rates, short-term symptom changes, weight gain and extrapyramidal side-effects. Trials were identified using a combination of electronic (Cochrane Central, EMBASE, MEDLINE and PsycINFO) and manual searches.ResultsFifteen randomised controlled trials with a total of 2522 participants were included. No significant differences between atypical and typical drugs were found for discontinuation rates (odds ratio (OR) = 0.7, 95% CI 0.4 to 1.2) or effect on symptoms (standardised mean difference (SMD) = –0.1, 95% CI –0.2 to 0.02). Participants on atypical antipsychotics gained 2.1 kg (95% CI 0.1 to 4.1) more weight than those on typicals, whereas those on typicals experienced more extrapyramidal side-effects (SMD = –0.4, 95% CI –0.5 to –0.2).ConclusionsThere was no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile.


2010 ◽  
Vol 177 (1-2) ◽  
pp. 77-83 ◽  
Author(s):  
Michael P. Caligiuri ◽  
Hans-Leo Teulings ◽  
Charles E. Dean ◽  
Alexander B. Niculescu ◽  
James B. Lohr

1998 ◽  
Vol 43 (6) ◽  
pp. 596-604 ◽  
Author(s):  
Ralph Lewis

Objective: To review the existing literature on the efficacy and tolerability of antipsychotics for adolescent psychosis. The review focuses in particular on literature regarding adverse effects that are thought to have an increased incidence in young patients and on the possible neurobiological bases for such differential sensitivity. Method: Pertinent studies were sought using Medline searches, supplemented by selected bibliographies, and reviewed. Results: There is a relative paucity of research in this area; in particular, well-controlled trials are lacking. The existing literature suggests fairly good efficacy of both typical and atypical antipsychotics in the treatment of psychotic disorders in children and adolescents. However, the incidence of certain side effects, particularly extrapyramidal symptoms (EPS), is found to be higher in young patients compared with adults. Positron emission tomography (PET) receptor studies in adults have demonstrated that the incidence of EPS is related to dose-dependent dopamine type-2 (D2) receptor occupancy and that there is a significant relationship between the number of these receptors and age. Conclusions: Improved tolerability is leading to the increasing use of atypical antipsychotics for adolescent patients, though these new drugs do have specific adverse effects of their own. There is a need for more controlled studies of atypical antipsychotics in children and adolescents. In particular, dose-finding studies are needed to determine the optimal dose range to produce the greatest improvement with the least side effects for each of these new drugs.


2011 ◽  
Vol 199 (4) ◽  
pp. 269-271 ◽  
Author(s):  
Stefan Leucht ◽  
John M. Davis

SummaryThe classification system of atypical and typical antipsychotics has created a lot of confusion and might be abandoned. Nevertheless, to say that all drugs are the same and that therefore it does not matter which drug is given is wrong. Both typical and atypical antipsychotics differ in side-effects, mechanisms of action, cost and efficacy. The available choice of antipsychotics should be adapted to individual patients in a shared decision-making process.


Author(s):  
Lavanya Nagaraj ◽  
Naveen Kumar Madalageri

ABSTRACTBackground: Schizophrenia is one of most serious chronic psychiatric disorder, which affects about 1% of population. Treatment of schizophrenia comprises of typical antipsychotics and or atypical antipsychotics. Typical antipsychotics like haloperidol have extrapyramidal side effects which limit their use in chronic cases. Atypical antipsychotics though have better treatment response, they have metabolic side effects like hypercholesteremia, hypertriglyceridemia and hyperglycaemia. As there is paucity of data in Indian population the present study has been taken up to compare the metabolic side effects of risperidone and olanzapine in the treatment of schizophrenic patients in a tertiary care hospital.Methods: It was a comparative study conducted on 60 patients of Schizophrenia for one year in a tertiary care hospital. The study subjects were randomly assigned into 2 groups of 30 patients each, where group 1 were treated with atypical antipsychotic drug risperidone and group 2 with Olanzapine and both groups received the treatment for one year. Metabolic side effects like hypercholesteremia, hypertriglyceridemia and hyperglycaemia were evaluated and compared over a period of one year.Results: Both risperidone and olanzapine were associated with comparable baseline to endpoint increase in metabolic side effects. However, risperidone treated subjects had significantly less metabolic side effects compared to olanzapine.Conclusions: Apart from total cholesterol and triglycerides, other metabolic side effects were less in risperidone treated patients than olanzapine treated patients.


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