Antipsychotic and Neuroleptic Medications for Schizophrenia (Nursing)

00:00 Now let's think about the antipsychotic medications.

00:04 The neuroleptic medications.

00:06 So these are the medications that we give to patients to treat their psychosis.

00:14 Now there are first generation and second generation antipsychotics.

00:19 And the first generation are associated with significant side effects.

00:27 And that is cognitive slowing.

00:30 So people who are on the first generation antipsychotics have a harder time answering questions.

00:37 They may be slower in how they answer you.

00:44 They have real impairments in cognition and being able to process thoughts and respond.

00:53 And they may have movement disorders, and we call them aims, their movement disorders that reflect tardive dyskinesia, or extrapyramidal side effects and their involuntary movements.

01:11 Also, this is important because tardive dyskinesia, the symptom that we see with the first generation, this is irreversible.

01:22 So once it appears, we can't take it away.

01:26 Let's talk a little bit about the first generation antipsychotics.

01:30 Antipsychotics are D-2 antagonists.

01:34 And unfortunately, they are associated with the risk of severe extrapyramidal symptoms.

01:41 What are extrapyramidal symptoms? So those are those body movements that are involuntary.

01:47 And primarily, we see the first generation antipsychotics really work well with the positive symptoms of schizophrenia.

01:56 But not so much with the negative symptoms.

02:00 So what are some of the more common first generation antipsychotics? Well, Haloperidol or Haldol.

02:09 And then we have a Chlorpromazine, which is Thorazine.

02:13 And you know, what they used to call Thorazine.

02:16 When Thorazine first was discovered, they called it lobotomy in a pill.

02:22 So that lets you know how intense Thorazine can be for patients.

02:29 And we also have Thioridazine which is Mellaril.

02:35 And then we have Loxitane or Loxpine.

02:38 And these are our most common first generation antipsychotics.

02:43 Now we have second generation antipsychotics that they too may slow or impair some cognitive functioning.

02:51 But our second generation antipsychotics, although they are associated with an increased risk for metabolic syndrome, which I'm going to talk about.

03:03 They also are going to be able to work with the both positive and negative symptoms.

03:11 So that is really important that it's taking care of both the positive and the negative symptoms of psychosis.

03:21 So what are some of our commonly use second generation antipsychotics, and you may recognize some of these and you may also recognize that these are also used with other mental illnesses that may have psychotic features.

03:36 Like Aripiprazole or also known as Abilify.

03:40 Risperidone, which is Risperdal.

03:43 Quetiapine which is Seroquel.

03:46 Clozapine which is Clozaril.

03:48 Ziprasidone which is Geodon.

03:53 And Olanzapine, which is called Zyprexa.

03:56 So these medications, when we're putting our patients on the second generation medications, we really have to monitor their metabolic panel, because they may end up gaining weight.

04:11 We might find that they're getting some heart disease, we may find that the medications themselves and taking away the psychosis and the symptoms of psychosis, actually have put them at higher risk for diabetes.