Please reply to each post with 1-2 paragraphs, including references.
Post 1: Anita
There are several antipsychotics available for patients with psychotic disorders. Select an antipsychotic medication and discuss its use, potential side effects, dosing, mechanisms of action, and the receptors it affects in the brain?
For this week’s discussion, the antipsychotic medication I’m focusing on is Risperidone (Risperdal). It is prevalence at my hospital quite a lot, and used for many patients with antipsychotic problems. It is commonly used to treat schizophrenia, behavioral disturbances, post-traumatic-stress-disorder, bipolar disorder, and irritability associated with impulse control. It works by antagonizing dopamine D2 receptors and serotonin 5-HT2A receptors in the brain. Specifically, 5HT7 antagonist properties may contribute to antidepressant actions. Risperidone is a second-general antipsychotic medication that is also known by the brand name Risperdal. It is commonly used to treat many psychotic disorders, it can help reduce hallucinations, delusions, and mood instability in patients with these conditions. It can also greatly improve the quality of life for those who benefit from its use. So, before prescribing risperidone, healthcare providers will make sure that they conducted an evaluation of the patient medical history and symptoms to determine if the medication is appropriate. Check the severity of the psychiatric disorder, the patient’s response to other previously used antipsychotic medication, and possible potential risks or contraindications. It is imperative the healthcare providers discuss the benefits and risks of risperidone with the patient before making a decision to prescribe the medication.
Side effects of Risperidone include weight gain, sedation, and extrapyramidal symptoms such as tremors or muscle stiffness. Dosing typically starts at a low dose and is adjusted based on the patient’s response and tolerance. These side effects range from relatively minor tolerability issues (e.g., mild sedation or dry mouth) to very unpleasant (e.g., constipation, akathisia, sexual dysfunction) to painful (e.g., acute dystonias) to disfiguring (e.g., weight gain, tardive dyskinesia) to life‐threatening (e.g., myocarditis, agranulocytosis) ( By blocking dopamine and serotonin receptors, Risperidone helps to alleviate symptoms of psychosis and mood disorders. Regular monitoring by healthcare providers is essential to manage side effects and ensure optimal treatment outcomes.
In conclusion, risperidone can be a valuable tool in managing psychiatric disorders when used appropriately and with close monitoring. It is important for healthcare providers to carefully evaluate each patient’s individual situation before prescribing risperidone and to educate patients about the medication. Open communication between the patient and healthcare provider is key to successful treatment with risperidone.
Post 2: Jenny
Quetiapine, marketed under the brand name Seroquel, is an atypical antipsychotic medication. Quetiapine is primarily prescribed for the treatment of psychotic disorders such as schizophrenia and bipolar disorder (both manic and depressive episodes). It can also be used off-label for other conditions like major depressive disorder (MDD), anxiety disorders, and insomnia (Ershadi et al., 2023).
Potential Side Effects
Common side effects include drowsiness, dizziness, dry mouth, constipation, and weight gain (Stahl, 2020). Serious side effects may include tardive dyskinesia (involuntary movements), neuroleptic malignant syndrome (NMS), and metabolic changes such as high blood sugar and cholesterol levels (Stahl, 2020). Quetiapine may also increase the risk of suicidal thoughts, especially in young adults.
Dosing
The dosing of quetiapine can vary depending on the condition being treated and the individual patient’s response. It is typically started at a low dose and gradually increased to achieve the desired therapeutic effect. Dosages can range from 25 mg to 800 mg per day, divided into 1 to 3 doses (Stahl, 2020).
Mechanism of Action
Quetiapine’s exact mechanism of action is not fully understood, but it is believed to involve its interactions with various neurotransmitter receptors in the brain. It has both antagonist and agonist effects on several receptors. Dopamine receptors (particularly D2 and D3 receptors): Antagonism at these receptors is thought to contribute to quetiapine’s antipsychotic effects (Stahl, 2013).
Receptors it Affects
Serotonin receptors, particularly 5-HT2A and 5-HT2C receptors. Antagonism at these receptors may also play a role in its therapeutic effects, especially in treating mood disorders (Stahl, 2013). Quetiapine has antagonistic effects on histamine receptors, contributing to its sedative properties (Stahl, 2013). Quetiapine also antagonizes alpha-1 adrenergic receptors, which may contribute to its side effects such as orthostatic hypotension and sedation (Stahl, 2013).