Psychiatric Drugs and Medications Q 41

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Antipsychotic drugs are indicated:

  

     A. For the treatment of Tourette's syndrome

     B. For the treatment of major depression

     C. As an adjunct in the management of seizures

     D. To cure psychotic disorders

    

    

Correct Answer: A. For the treatment of Tourette’s syndrome.

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Haloperidol (Haldol) is used for this syndrome. Haloperidol and pimozide are the antipsychotics most commonly used for this syndrome. Tourette disorder is an off-label indication for second-generation antipsychotics.

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Option B: Major depression is an affective disorder. When psychotic symptoms accompany depression, antipsychotics may be used to manage the symptoms. However, this choice does not address that situation. First or second-generation antipsychotics, along with an antidepressant, is the treatment of choice for depression with psychotic features. Olanzapine and fluoxetine, as a combination therapy, have FDA approval for treatment-resistant depression.

Option C: Antipsychotics are used with caution in the presence of a history of seizures. Generally, the antipsychotics decrease the seizure threshold. Among the first generation antipsychotics, chlorpromazine appears to be the one most associated with the greatest risk of seizures, whereas in the newer antipsychotics clozapine is thought to be the most likely to cause seizures of that group of medications.

Option D: Antipsychotics are used to ameliorate, reduce, or manage psychotic symptoms; they do not provide a cure. The first-generation antipsychotics work by inhibiting dopaminergic neurotransmission. Their effectiveness is best when they block about 72% of the D2 dopamine receptors in the brain. They also have noradrenergic, cholinergic, and histaminergic blocking action.

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