Typical antipsychotics (conventional) (FGA)
• Treats positive (+) symptoms only appropriate for the acute and chronic
management of schizophrenia and
... [Show More] psychosis.
• Non-selectively blocks dopamine D2 receptors, specifically in mesolimbic pathway;
also blocks Ach (Muscarinic), histamine, NE
Five main SE of FGAs
• Sedation
• Postural Hypotension
• Lower seizure threshold
• Anticholinergic side effects
• Photosensitive
Haloperidol-High-Appropriate for acute, severe agitation and aggression-Butyrophenones
• Initial oral dose 1-15mg/day (can give once daily or divide;
• Usual dose 1-40mg/day (orally);
• Max dose 100mg/day
• Tablets 0.5, 1, 2, 5, 10, 20mg; Concentrate 2mg/ml; Injection 5mg/ml
• Half-life 13-38
• Higher risk for EPS and TD
• Avoid in older adults due to increased risk of cerebrovascular accident (CVA), cognitive
decline, and death in persons with dementia and with dementia-related psychosis.
Fluphenazine-Medium-Psychotic D/Os
• Initial oral dose 0.5-10mg/day divided doses;
• Usual dose 1-20mg day;
• Max dose40mg/day
• Tablet 1, 2.5, 5, 10mg; Elixer 2.5mg/ml; Concentrate 5mg/ml
• Half-life 15 hours
Thiothixene-Medium
• Initial dose 5-10mg/day;
• Usual dose 15-30mg/day;
• Max dose 60mg/day divided
• Capsules 2, 5, 10mg
• Half-life 3.4-34 hours
Thioridazine-Low-2nd line due to QTc issues
• Initial dose 50-100mg/3xday/increase gradually;
• Usual dose 200-800mg divided;
• Max dose 800mg/day
• Tablets 10, 15, 25, 50, 100mg
• Metabolized by CYP450 2D6
Chlorpromazine-Low-2nd line due to QTc issues -schizophrenia-DA 2 antagonist
• Usual dose 200-800mg divided; maximum 800mg/day
• Psychosis-increase dose until symptoms are controlled; after 2 weeks reduce to lowest
effective dose
• Can improve in one week but may take several weeks for full effect on behavior
• Tablet 10, 25, 50, 100, 200mg
• Half-Life 8-33 hours
• Phenothyazine
• SXS-Dry mouth, pupil dilation, blurred vision, cog impair, constipation, urinary
retention, tachycardia
Mesoridazine-Low-off market due to dangerous side effects, including irregular heartbeat and
QT prolongation.
*Low potency meds require higher doses to achieve efficacy
*Low potency meds have more anticholinergic, antihistaminic, and α 1 properties resulting in
more sedation than higher potency meds.
*High risk for developing hyperprolactinemia and EPS (negative symptoms aren’t affected by
FGAs only positive symptoms [Show Less]