Classification of Anti Psychotics

Antipsychotics are classified into 2 main categories each class works differently and has a distinct side effect profile.

1. Typical (First-Generation) Antipsychotics

These are older antipsychotics that primarily work by blocking dopamine D2 receptors, which can lead to a reduction in symptoms of psychosis, such as hallucinations and delusions. However, they are more likely to cause extrapyramidal side effects (movement disorders).

•  High potency

                  1. Haloperidol (Haldol)

                  2. Fluphenazine (Prolixin)

                  3. Thiothixene (Navane)

•    Medium Potency

          

                  1. Perphenazine (Trilafon)

                  2. Loxapine (Loxitane)

•     Low Potency

                   1. Chlorpromazine (Thorazine)

                   2. Thioridazine (Mellaril)

2. Atypical (Second-Generation) Antipsychotics

These are newer antipsychotics that target both dopamine and serotonin receptors, leading to fewer movement-related side effects but potentially increasing the risk of metabolic issues such as weight gain, diabetes, and dyslipidemia.

• Clozapine (Clozaril): Effective for treatment-resistant schizophrenia but requires regular blood monitoring due to the risk of agranulocytosis.
• Risperidone (Risperdal): Used for schizophrenia, bipolar disorder, and irritability associated with autism.
• Olanzapine(Zyprexa): Known for its efficacy but also associated with significant weight gain and metabolic side effects.
• Quetiapine (Seroquel): Commonly used for schizophrenia and bipolar disorder and as an adjunct in major depressive disorder.
• Aripiprazole (Abilify): Has a unique mechanism of action as a partial agonist at dopamine receptors, which can lead to a lower risk of side effects.
• Ziprasidone (Geodon): Less likely to cause weight gain but may have a risk of prolonging the QT interval (a heart rhythm issue).
• Paliperidone (Invega): The active metabolite of risperidone, used for schizophrenia and schizoaffective disorder.
• Lurasidone (Latuda): Used for schizophrenia and bipolar depression, with a relatively lower risk of metabolic side effects.

3. Third-generation antipsychotics

These are a subset of atypical antipsychotics that work as partial agonists at dopamine receptors, offering a balance between efficacy and side effects.

• Aripiprazole (Abilify): Often considered the prototype of third-generation antipsychotics.
• Brezpiprazole (Rexulti): Similar to aripiprazole but with a different side effect profile
• Cariprazine (Vraylar): Used for schizophrenia and bipolar with a focus on both positive and negative symptoms.

Each of these classes has its own indications, benefits, and potential side effects, making the choice of antipsychotic highly individualized based on the patient's specific needs and health status.

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