Atypical antipsychotics

Atypical antipsychotic agents include risperidone, olanzapine, ziprasidone, and aripiprazole, quetiapine and clozapine.

Used for treating schizophrenia, bipolar disorder, and depression.

Second generation antipsychotic drugs.

Atypical antipsychotics have antagonist activity at both D2 and serotonin 5-hydroxytryptamine type 2A receptors and have fewer side effects related to movement disorders than


 first generation antipsychotics, but do not improve efficacy and associated with adverse metabolic effects and weight gain.

Cardiometabolic adverse effects in children and adolescents include weight gain, obesity, hypertension, impaired glucose tolerance, and lipid abnormalities.

Cardiometabolic , adverse reactions in children and adolescents can predict for adult obesity, the metabolic syndrome, cardiovascular morbidity and malignancy (Sinaiko AR).

Evidence exists that suggests young people more to vulnerable induced weight gain.

In a nonrandomized Second Generation Anti-psychotic Treatment Indications, Effectiveness and Tolerability in Youth (SATIETY) study of youth aged four years to 19 years: at a median of 10.8 weeks olanzapine was associated with an increased weight of 8.5 kg, quetiapine was associated with a 5.3 kg weight gain, risperidone with a 4.4 kg weight gain, and with aripiprazole 4.4 kg weight gain, compared with a minimal weight change of 0.2 kg in untreated comparison group (Corell CU).

Less likely to cause extrapyramidal side effects, tardive dyskinesias and more favorable affect on cognitive dysfunction than older antipsychotic medications.

May cause weight gain, hyperlipidemia and glucose intolerance.

Clozapine and olanzapine produce the most weight gain.

Quetiapine and risperidone produce immediate weight gain.

Ziprasidone and aripiprazole can also cause weight gain.

Treatment for schizophrenia and bipolar disease.

Fewer adverse cardiovascular effects such associated orthostatic hypotension, and repolarization delays than to conventional antipsychotic drugs.

Less sedation, postural instability and fewer falls than with conventional antipsychotic agents.

Increased risk of stroke and mortality associated with the use of these agents in elderly patients with dementia.

Mortality among dementia patients receiving antipsychotic medications is on the average 1.6-1.7 times as high in patients with dementia than among patients with placebo.

FDA has an advisory warning of an increased risk of death when atypical antipsychotics are used in dementia.



Atypical antipsychotics have some benefits when used in addition to other treatments in major depressive disorder.


There is, however, a greater risk of side effects with their use compared to using traditional antidepressants.


Antipsychotics may be used for obsessive–compulsive disorder, posttraumatic stress disorder, personality disorders, Tourette syndrome, autism and agitation in those with dementia.

Evidence does not support the use of atypical antipsychotics in eating disorders or personality disorder.



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