Atypical antipsychotic drugs are used to treat schizophrenia and other psy-
chotic disorders for patients who do not respond to the typical antipsychotic
medication.
A list of antipsychotic drugs is provided in the Appendix. Detailed tables
show doses, recommendations, expectations, side effects, contraindications, and
more; available on the book’s Web site (see URL in Appendix).Phenothiazines
Phenothiazines are divided into three groups. These are aliphatic, piperazine,
and piperidine. Each category has different side effects (see Table 15-2). The
aliphatic group produces a strong sedative effect, decreases blood pressure, and
may moderate extrapyramidal symptoms (EPS). Chlorpromazine is a member of
this group.
The piperzine group produces a low sedative effect and a strong anti-
emetic effect, more EPS, and little effect on blood pressure. Included in this
group are prochlorperazine (Compazine), fluphenazine (Prolixin), perphenazine
(Trilafon), and trifluoperazine (Stelazine).
The piperidine group includes mesoridazine besylate (Serentil) and thiori-
dazine HCl (Mellaril). These produce few EPS or anti-emetic effects and can
cause hypotension.Anxiolytics
Anxiolytics are medications used to treat anxiety and insomnia. These have
replaced sedatives that were traditionally used because they have fewer and less
potent side effects, especially if an overdose of the medication is given to the
patient. Benzodizepine is the major group of anxiolytics.
Anxiolytics are prescribed when the patient’s anxiety reaches a level where the
patient becomes disabled and is unable to perform normal activities. Anxiolytics
have a sedative-hypnotic effect on the patient, but not an antipsychotic effect.
There are two types of anxiety: primary anxiety and secondary anxiety.
Primary anxiety is not caused by a medical condition or drug use but may be sit-
uational. Secondary anxiety is caused by a medical condition or by drug use.
Anxiolytics are usually not administered for secondary anxiety unless the sec-
ondary cause is severe or untreatable. Instead, the secondary cause is treated.
Benzodizepines are prescribed to treat severe or prolonged anxiety, but are
also used to treat convulsions, hypertension, and as a sedative-hypnotic and(^296) CHAPTER 15 Nervous System Drugs