Antihypertensives, CNS depressants, Epinephrine or dopamine in combination with haloperidol or phenothiazine
Additive and potentially severe hypotension
Oral anticoagulants with phenothiazine
Less effective anticoagulant effects
Drugs that prolong Q T intervals
Drugs that trigger orthostatic hypotension
Drugs with anticholinergic effects, prescription and over-the-counter drugs
Additive anticholinergic effects including anticholinergic toxicity, which includes flushing, hypertension, dry mouth, mydriasis, urinary retention, altered mental status, tachycardia, and tremelousness
Drug trade/ Generic names
First-Generation (Conventional or typical)
Strong antagonist to Dopamine receptors, blocking the action of dopamine. Antagonist to muscarinic receptors for acetylcholine, adrenergic receptors for norepinephrine and histamine receptors.
Extrapyramidal symptoms (EPS) such as acute dystonia, akathisia, dyskinesia, tardive dyskinesia, and pseudoparkinsonism. In women, amenorrhea, and in men, gynecomastia. Anticholinergic side effects, low seizure threshold, tachycardia, hypotension, and ejaculatory dysfunction.
Perform AIMS test with conventional antipsychotics. Monitor for signs of dry mouth, sedation, blurred vision, and dry mouth. Monitor vital signs
Dopamine and serotonin antagonists (blockers). Thought to decrease psychosis.
Weight gain, insulin resistance, metabolic syndrome, sexual dysfunction.
Clozaril – 1st atypical antipsychotic to be used. Frequent monitoring of WBCs every 1-2 weeks due to bone marrow suppression and agranulocytosis.
Risperdal – high risk for EPS. Monitor weight.
Issues in Antipsychotic Maintenance Therapy