EPS Profiles: The Atypical Antipsychotics: Are Not All the Same

@article{Weiden2007EPSPT,
  title={EPS Profiles: The Atypical Antipsychotics: Are Not All the Same},
  author={Peter J. Weiden},
  journal={Journal of Psychiatric Practice},
  year={2007},
  volume={13},
  pages={13-24}
}
  • P. Weiden
  • Published 1 January 2007
  • Medicine
  • Journal of Psychiatric Practice
Within the first few years after chlorpromazine began to be used to treat psychosis, it was observed that it could cause many kinds of neurologic reactions that resembled those seen in idiopathic Parkinson's disease. These reactions were termed "extrapyramidal side effects" (EPS) because of their resemblance to the signs of Parkinson's disease, which were associated with degeneration of the dopamine nerve tracks located in the extrapyramidal region of the central nervous system. Eventually this… 
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References

SHOWING 1-10 OF 81 REFERENCES
Atypical antipsychotics in the EPS-vulnerable patient
TLDR
The existing data, coupled with the lack of required blood monitoring, have led some experts to recommend quetiapine as the drug of choice for treatment of drug-induced psychosis in patients with parkinsonism.
New atypical antipsychotic medications.
TLDR
The drugs' unique profiles with regard to other side effects may make it possible to tailor treatment more individually to patients, and further refinement of the clinical utility of these drugs awaits their widespread use in mainstream clinical settings.
Extrapyramidal Side Effects of Antipsychotic Treatment: Scope of Problem and Impact on Outcome
  • R. Tandon, M. Jibson
  • Psychology, Medicine
    Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
  • 2002
TLDR
The newer generation of “atypical” antipsychotic agents are significantly better than conventional agents with regard to EPS, and this EPS advantage of atypical antipsychotics translates into several important benefits, including better negative symptom efficacy, less dysphoria, less impaired cognition, a lower risk of TD, and better overall outcome.
Efficacy of newer generation antipsychotics in the treatment of schizophrenia
TLDR
Data thus far do not support assertions of differential efficacy between risperidone, olanzapine, and quetiapine but there are clear differences in their side-effect profiles and these are briefly summarized.
Half a century of antipsychotics and still a central role for dopamine D2 receptors
  • S. Kapur, D. Mamo
  • Medicine, Psychology
    Progress in Neuro-Psychopharmacology and Biological Psychiatry
  • 2003
TLDR
A hypothesis is proposed wherein psychosis is a state of aberrantSalience of stimuli and ideas, and antipsychotics, via modulation of the mesolimbic dopamine system, dampen the salience of these symptoms, ensuring the resolution of symptoms.
Relationship between dopaminergic and serotonergic neuronal activity in the frontal cortex and the action of typical and atypical antipsychotic drugs
TLDR
Evidence is reviewed here the evidence that some, or all, of these advantages of the new generation of antipsychotic drugs are related to their actions at serotonin and dopamine receptors.
Significance of neuroleptic dose and plasma level in the pharmacological treatment of psychoses.
TLDR
Assessment of immediate and later follow-up treatment of psychotic patients indicates that moderate doses are adequate for most patients, and moderate doses of neuroleptics appear, on average, to be about as effective as, and probably safer than, the larger doses that have been popular in the United States in recent years.
The mechanism of action of novel antipsychotic drugs.
  • H. Meltzer
  • Psychology, Medicine
    Schizophrenia bulletin
  • 1991
TLDR
The chief evidence for this position is that clozapine (CLOZ) does not differ from typical antipsychotic drugs in these regards but is more effective than typical neuroleptic drugs.
Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine.
TLDR
In this relatively brief study, the apparently increased comparative risk of agranulocytosis requires that the use of clozapine be limited to selected treatment-resistant patients.
Mechanisms of action of second generation antipsychotic drugs in schizophrenia: insights from brain imaging studies
TLDR
The importance of therapeutic strategies aimed at directly increasing prefrontal DA, D1 receptor transmission or NMDA transmission to enhance the therapeutic effect of moderate D2 receptor antagonism is highlighted.
...
1
2
3
4
5
...