Pharmacology · MU Sofia

32. Neuroleptics.

Covers the classification of neuroleptics into typical and atypical groups, their dopamine and serotonin receptor actions and the extrapyramidal effects that follow. It then goes through pharmacokinetics, side effects including neuroleptic malignant syndrome, key drug interactions, clinical indications and off-label uses, and cautions in pregnancy and lactation. It closes with recap questions.

Inside: 8 sections · 5 labelled pictures · 10 flashcards · 4 min

Topic 31 of 93 in the MU Sofia syllabus for Pharmacology (Dental Medicine, Year 3). The free AceMed note covers it in 8 sections, about 555 words (4 min of reading), with 10 flashcards.

In this note

  1. Neuroleptics (Antipsychotic Drugs)
  2. Classification
  3. Pharmacodynamics
  4. Pharmacokinetics
  5. Side Effects
  6. Drug Interactions
  7. Therapeutic Uses
  8. Special Considerations in Pregnancy & Lactation

Neuroleptics (Antipsychotic Drugs)

Neuroleptics, also known as antipsychotic drugs, are medications primarily used to manage and treat symptoms of psychosis, including delusions, hallucinations, paranoia, and disordered thinking. These drugs are essential in the treatment of schizophrenia, bipolar disorder, and other psychiatric conditions.

Classification

  • Typical (First-Generation) Antipsychotics:
  • Haloperidol, Chlorpromazine, Fluphenazine, Perphenazine
  • Atypical (Second-Generation) Antipsychotics:
  • Risperidone, Olanzapine, Clozapine, Aripiprazole

Pharmacodynamics

  • Typical Antipsychotics (First-Generation):
  • These drugs block dopamine D2 receptors in the brain, particularly in the mesolimbic pathway, reducing psychotic symptoms.
  • However, dopamine blockade in the nigrostriatal pathway can lead to extrapyramidal symptoms (EPS) such as:
  • Tardive dyskinesia (involuntary movements)
  • Parkinsonism (tremors, rigidity)
  • Akathisia (restlessness)
  • Dystonia (muscle contractions)
  • Atypical Antipsychotics (Second-Generation):
  • These drugs block both dopamine D2 receptors and serotonin (5-HT2A) receptors, balancing dopamine and serotonin activity in the brain.
  • This mechanism reduces psychotic symptoms while also lowering the risk of EPS.
  • Some atypicals (e.g., clozapine) also have effects on glutamate and histamine receptors, contributing to their efficacy in treatment-resistant schizophrenia.

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