Antipsychotic Agents

Agents

General Comments
- First-Generation Antipsychotic Agents Have a Higher Incidence of Extrapyramidal Adverse Effects and Tardive Dyskinesia, as Compared to the Second-Generation Antipsychotic Agents
Low-Potency Agents: higher anticholinergic side effects, lower extrapyramidal side effects
- Chlorpromazine (Largactil, Thorazine) (see Chlorpromazine)
- Thioridazine (Mellaril, Novoridazine, Thioril) (see Thioridazine)
High-Potency Agents: lower anticholinergic side effects, higher extrapyramidal side effects
- Fluphenazine (Prolixin) (see Fluphenazine)
- Haloperidol (Haldol) (see Haloperidol)
- Loxapine (Loxitane, Adasuve) (see Loxapine)
- Perphenazine (Trilafon) (see Perphenazine)
- Pimozide (Orap) (see Pimozide)
- Thiothixene (Navane) (see Thiothixene)
- Trifluoperazine (Stelazine) (see Trifluoperazine)

General Comments
- Second-Generation Antipsychotic Agents are Generally Believed to Have a Lower Incidence of Extrapyramidal Adverse Effects and Tardive Dyskinesia, as Compared to the First-Generation Antipsychotic Agents: likely related to the weaker affinity of these agents for the dopamine D2 receptor
- However, Other Studies Have Suggested that the Differences Between First and Second-Generation Antipsychotics with Regard to Extrapyramidal Side Effects May Be More Minimal than Has Been Previously Believed (Lancet, 2003) [MEDLINE]
Aripiprazole (Abilify) (see Aripiprazole)
Asenapine (see Asenapine)
Brexpiprazole (Rexulti) (see Brexpiprazole)
Cariprazine (see Cariprazine)
Clozapine (Clozaril) (see Clozapine)
- Epidemiology
  - Clozapine Has a Low Risk of Acute Extrapyramidal Effects, as Well as a Rare Association with Tardive Dyskinesia
Iloperidone (Fanapt, Zomaril) (see Iloperidone)
Lurasidone (Latuda) (see Lurasidone)
Olanzapine (Zyprexa) (see Olanzapine)
- Epidemiology
  - Highest Risk of Tardive Dyskinesia Among the Second-Generation Antipsychotics
Paliperidone (Invega) (see Paliperidone)
Pimavanserin (Nuplazid) (see Pimavanserin)
Quetiapine (Seroquel) (see Quetiapine)
Risperidone (Risperdal) (see Risperidone)
- Epidemiology
  - Highest Risk of Tardive Dyskinesia Among the Second-Generation Antipsychotics
Ziprasidone (Geodon) (see Ziprasidone)