616 CHAPTER 15
involuntary jerks or dance-like movements of the arms and legs (Julien et al., 2011; Preston
et al., 2008; Stahl, 2013).
The atypical antipsychotics may also suppress dopamine but to a much greater
degree in the one dopamine pathway that seems to cause psychotic problems. These
drugs also block or partially block certain serotonin receptors, resulting in fewer neg-
ative side effects and occasionally some improvement in the negative symptoms of
schizophrenia (Julien et al., 2011; Preston et al., 2008; Stahl, 2013). Despite their effective-
ness, the atypical antipsychotics may also have unwanted side effects, such as weight
gain, diabetes, blood lipid level changes, or changes in the electrical rhythms of the heart
(Julien et al., 2011). One of these, clozapine, can cause a potentially fatal reduction in the
white blood cells of the body’s immune system in a very small percentage of people. For
this reason, the blood of patients on clozapine is closely monitored, and it is not consid-
ered to be a first choice when selecting treatment options but is used more often when
other antipsychotic drugs are ineffective (Stahl, 2013).
Newer classes of atypical antipsychotics include partial dopamine agonists that affect
the release of dopamine rather than blocking its receptors in the brain and other agents
that have agonistic or antagonistic properties for dopamine and serotonin (Stahl, 2013). (An
agonist facilitates, whereas an antagonist blocks or reduces effects.) Drugs are also being
investigated that are linked to the actions of glutamate. to Learning Objective 2.3.
How long do people generally have to take these antipsychotic
medications?
In some cases, a person might have a psychotic episode that lasts only a few
months or a few years and may need drug treatment only for that time. But in most cases,
Table 15.3 Types of Drugs Used in Psychopharmacology
Classification Treatment Areas Side Effects Examples
Antipsychotic:
Typical
antipsychotic
Positive (excessive)
symptoms such
as delusions or
hallucinations
Motor problems,
tardive dyskinesia
Chlorpromazine,
droperidol, haloperidol
Antipsychotic:
Atypical
antipsychotic
Positive and some
negative symptoms
of psychoses
Fewer than typical
antipsychotic;
clozapine may cause
serious blood disorder
Risperidone, clozapine,
aripiprazole
Antianxiety: Minor
Tranquilizers
Symptoms of
anxiety and phobic
reactions
Slight sedative effect;
potential for physical
dependence
Alprazolam, lorazepam,
diazepam
Antimanic Manic behavior Potential for toxic
buildup
Lithium, anticonvulsant
drugs
Antidepressants:
MAOIs
Depression Weight gain,
constipation, dry
mouth, dizziness,
headache, drowsiness,
insomnia, some sexual
arousal disorders
Iproniazid, isocarboxazid,
phenelzine sulfite,
tranylcypromine sulfate
Antidepressants:
Tricyclics
Depression Skin rashes, blurred
vision, lowered blood
pressure, weight loss
Imipramine, desipramine,
amitriptyline, doxepin
Antidepressants:
SSRIs
Depression Nausea, nervousness,
insomnia, diarrhea,
rash, agitation,
some sexual arousal
problems
Fluoxetine, sertraline,
paroxetine
Interactive
