Antipsychotic Agents

Antipsychotic agents are drugs that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia, senile dementia, transient psychosis following surgery or myocardial infarction, etc. These drugs are often referred to as neuroleptics referring to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, vomiting, and itching.

The major chemical subgroups of older antipsychotic drugs are the phenothiazines (e.g. chlorpromazine, thioridazine, fluphenazine) the thioxanthense (e.g. thiothixene), and the butyrophenones (e.g. haloperidol).

Newer "second generation" drugs of varied heterocyclic structure such as clozapine, loxapine, olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole may be somewhat more effective and less toxic than the older drugs.

Antipsychotic agents are well absorbed when given orally and, because they are lipid soluble, readily enter the central nervous system and most other body tissues. Many are bound extensively to plasma proteins. These drugs require metabolism by liver enzymes before elimination and have long plasma half-lives that permit once-daily dosing.

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