What Are First-Generation Antipsychotics?
First-generation antipsychotics (FGA) are a class of medications used to treat mental illness...
they have been around for more than 50 years and have been the standard for treating everything from psychosis to schizophrenia to anxiety.
- What are the individual FGA?
- How do FGA work?
- What are the FGA side effects?
- What are the more serious FGA side effects?
- What are FGA monitoring parameters?
FGA affect a brain chemical known as dopamine.
Common FGA side effects include: sedation, fatigue, headaches, blurred vision, weight gain, low blood sugar, sleep disturbances, stomach discomfort, constipation and vomiting.
Orthostatic hypotension - Orthostatic hypotension is a sudden drop in blood pressure when an individual stands or stretches. Orthostatic hypotension may lead to lightheadedness, dizziness and fainting. Therefore, individuals taking FGA should use caution when standing from the seated position.
Extrapyramidal symptoms (EPS) -
EPS are neurological disturbances in the area of the brain that controls motor coordination. EPS include: muscle stiffness, rigidity and tremors. Individuals may be placed on benztropine (Cogentin) or diphenhydramine (Benadryl) to help manage EPS.
Akathisia is a type of EPS characterized by a sense of restlessness, inability to sit still, nervousness, muscle discomfort and agitation.
Dystonia is a type of EPS manifested by a sudden spasm of muscles involving the
tongue, jaw and neck.
Tardive dyskinesia -
Tardive dyskinesia is an involuntary movement disorder which is potentially irreversible. Symptoms of tardive dyskinesia include: "pill-rolling" movements of the fingers, darting/writhing movements of the tongue, lip puckering, facial grimacing and other irregular movements.
Neuroleptic malignant syndrome -
neuroleptic malignant syndrome is a rare, toxic reaction to antipsychotics. The symptoms of neuroleptic malignant syndrome include: muscle stiffness, rigidity, elevated body temperature, increased heart rate/blood pressure, irregular pulse, and sweating.
Antipsychotics may disrupt the area of the brain that regulates temperature. Therefore, individuals taking antipsychotics may be very sensitive to heat.
FGA can lower individuals' seizure threshold and induce seizures in susceptible individuals, especially in those with a seizure disorder history.
FGA may slow electrical conduction in heart tissues and lead to an irregular heart beat (arrhythmia). Arrhythmias will show up on individuals' electrocardiogram (ECG) as a prolonged electrical impulse known as QTc-prolongation.
FGA monitoring parameters include: mental status changes, weight gain, blood pressure, heart rate, EPS and QTc-prolongation.
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