Atypical (2nd generation) antipsychotics

Risperidone 

  • – 1-2 mg/day, up to 4 mg/day

Olanzapine

  • – 5-10 mg/day, up to 20 mg/day

Aripiprazole

  • – 10-15 mg/day

Clozapine

Quetiapine

  • Dopamine & serotonin receptor antagonists (more selective than typical antipsychotics)

  • Increasingly being used for delusional parasitosis 🡪 lower risk of tardive dyskinesia & QT prolongation than Pimozide

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  • All: Sedation, ↑ QT interval
  • Risperidone: Anxiety, dizziness, rhinitis, ↑ prolactin 
  • Metabolic syndrome & anticholinergic (olanzapine, clozapine)

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  • Less extrapyramidal SE than typical antipsychotics