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The difference between first- and second-generation antipsychotics is a subject of debate. The second-generation antipsychotics are generally distinguishable by the presence of 5HT2A receptor antagonism and a corresponding lower propensity for extrapyramidal side effects compared to first-generation antipsychotics. [15]
The atypical antipsychotics (AAP), also known as second generation antipsychotics (SGAs) and serotonin–dopamine antagonists (SDAs), [1] [2] are a group of antipsychotic drugs (antipsychotic drugs in general are also known as tranquilizers and neuroleptics, although the latter is usually reserved for the typical antipsychotics) largely introduced after the 1970s and used to treat psychiatric ...
Typical antipsychotics (also known as major tranquilizers, and first generation antipsychotics) are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis (in particular, schizophrenia). Typical antipsychotics may also be used for the treatment of acute mania, agitation, and other conditions.
In older people with psychosis as a result of dementia, it may increase the risk of death. [6] It is unclear if it is safe for use in pregnancy. [6] Chlorpromazine was developed in 1950 and was the first antipsychotic on the market. [7] [8] It is on the World Health Organization's List of Essential Medicines.
Second-generation (atypical) antipsychotics: The concept of "atypicality" is from the finding that second generation antipsychotics (SGAs) have a greater serotonin/dopamine ratio than earlier drugs, and might be associated with improved efficacy (particularly for the negative symptoms of psychosis) and reduced extrapyramidal side effects.
Brexpiprazole, sold under the brand name Rexulti among others, is an atypical antipsychotic medication used for the treatment of major depressive disorder, schizophrenia, and agitation associated with dementia due to Alzheimer's disease. [11] [13] [14] The most common side effects include akathisia (a constant urge to move) and weight gain. [12]
Approximately one out of four individuals treated with first-generation antipsychotics have akathisia. [5] Prevalence rates may be lower for modern treatment as second-generation antipsychotics carry a lower risk of akathisia. [31] In 2015, a French study found an overall prevalence rate of 18.5% in a sample of outpatients with schizophrenia. [33]
Thioridazine (Mellaril or Melleril) is a first generation antipsychotic drug belonging to the phenothiazine drug group and was previously widely used in the treatment of schizophrenia and psychosis. The branded product was withdrawn worldwide in 2005 because it caused severe cardiac arrhythmias. However, generic versions are still available in ...
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