1. Risperidone – Binding Profile
5HT2A/D2 antagonist (high affinity for D2 receptors)
a 1 antagonist
a 2 antagonist
Tasman, A; Lieberman, J; Key, J; Maj, M. Psychiatry. 3rd ed. John Wiley & Sons, 2008
Schatzberg, AF, Nemeroff, CB. The American Psychiatric Publishing Textbook of Psychopharmacology. 4th ed.American Psychiatric Publishing, 2009

2. Risperidone – Prescribing Facts
Dosage range:
2 – 8 mg/day for acute psychosis and bipolar disorder
mg /day for children and elderly patients
25-50 mg IM every two weeks
Stahl, S M. The Prescriber's Guide. 4thd ed. New York: Cambrigde University Press; 2011

3. Risperidone – Prescribing Facts
Dosage forms:
Tablets: 0.25mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 6 mg.
Orally disintegrating tablets: 0,5 mg , 2 mg
Liquid: 1 mg/ml, 30 ml bottle
LAI: Risperidone microspheres for IM use. 25 mg, 37.5 mg, 50 mg
Stahl, S M. The Prescriber's Guide. 4thd ed. New York: Cambridge University Press; 2011

4. Risperidone – Clinical Profile
Approved for use in children and adolescents:
Schizophrenia, ages 13 and older
Acute mania/mixed mania, ages 10 and older
Autism related irritability in children, ages 5 -16
LAI approved for maintenance treatment of bipolar 1 disorder
Stahl, S M. The Prescriber's Guide. 4thd ed. New York: Cambridge University Press; 2011

5. Risperidone – Clinical Profile
Weight gain: intermediate risk.
Lower risk than olanzapine and clozapine
Higher risk than aripiprazole and ziprasidone
EPS risk is dose dependent.
A PET study found that risperidone occupies 75-80% of striatal D2 receptors at a dose of 6mg/day.
Prolactin elevation is a risk.
Tasman, A; Lieberman, J; Key, J; Maj, M. Psychiatry. 3rd ed. John Wiley & Sons, 2008
Schatzberg, AF, Nemeroff, CB. The American Psychiatric Publishing Textbook of Psychopharmacology. 4th ed.American Psychiatric Publishing, 2009

6. Paliperidone Metabolite of risperidone: 9-hydroxyl-risperidone
Available as LAI: paliperidone palmitate

7. Paliperidone– Binding Profile
5HT2A/D2 antagonist
a 1 antagonist
a 2 antagonist
Tasman, A; Lieberman, J; Key, J; Maj, M. Psychiatry. 3rd ed. John Wiley & Sons, 2008
Schatzberg, AF, Nemeroff, CB. The American Psychiatric Publishing Textbook of Psychopharmacology. 4th ed.American Psychiatric Publishing, 2009

8. Paliperidone- Prescribing Facts
Dosage range:
6 mg/day (up to 12 mg/day)
Dosage forms:
Extended release tablets: 3 mg, 6 mg, 9 mg
LAI - Paliperidone palmitate: 39 mg, 78 mg, 117 mg, 156 mg, 234 mg.
INVEGA [package insert]. Accessed at : November 2012

9. Paliperidone - Clinical Profile
First antipsychotic to be approved for schizoaffective disorder.
Paliperidone and risperidone are the two SGAs associated with hyperprolactinemia.

10. Quetiapine – Binding Profile
5HT2A/D2 antagonist
5HT1A partial agonist
H1 antagonist
a 1 antagonist
Tasman, A; Lieberman, J; Key, J; Maj, M. Psychiatry. 3rd ed. John Wiley & Sons, 2008
Schatzberg, AF, Nemeroff, CB. The American Psychiatric Publishing Textbook of Psychopharmacology. 4th ed.American Psychiatric Publishing, 2009

11. Quetiapine – Prescribing Facts
Dosage range:
mg/day for schizophrenia and bipolar mania
300 mg / day for bipolar depression
Dosage forms:
Tablets: 25 mg, 50 mg, 100 mg, 200 mg, 300 mg, 400 mg
XR tablets: 200 mg, 300 mg, 400 mg
Stahl, S M. The Prescriber's Guide. 4thd ed. New York: Cambrigde University Press; 2011

12. Quetiapine – Clinical Profile
Approved for:
Bipolar maintenance
Bipolar depression
Acute mania/mixed states
Adjunctive treatment of MDD
Stahl, S M. The Prescriber's Guide. 4thd ed. New York: Cambrigde University Press; 2011

13. Quetiapine – Clinical Profile
Adverse effects:
Most common adverse effects: somnolence and dizziness.
Orthostatic hypotension
About 7% of patients
Syncope is a possibility with rapid titration
Weight gain: intermediate risk
EPS: low risk
Used in patients with Parkinson’s disease and Lewy body dementia
Schatzberg, AF., Cole, JO, and DeBattista, C. Manual of Clinical Psychopharmacology. 7th ed.American Psychiatric Publishing, 2010.

14. Ziprasidone - Binding Profile
5HT2A/D2 antagonist
5HT1A partial agonist
5HT1D antagonist
5HT2C antagonist
Low affinity for H1, M1 and a 1 receptors
Tasman, A; Lieberman, J; Key, J; Maj, M. Psychiatry. 3rd ed. John Wiley & Sons, 2008
Schatzberg, AF, Nemeroff, CB. The American Psychiatric Publishing Textbook of Psychopharmacology. 4th ed.American Psychiatric Publishing, 2009

15. Ziprasidone – Prescribing Facts
Dosage range:
Schizophrenia: 40 – 200 mg/day
Bipolar disorder: mg/day
Maximum daily IM dose: 40 mg
Dosage forms:
Capsules: 20 mg, 40 mg 60 mg, 80 mg
Injection: 20 mg/mL
Stahl, S M. The Prescriber's Guide. 4thd ed. New York: Cambrigde University Press; 2011

16. Ziprasidone – Clinical Profile
Associated with QT prolongation:
Not dose dependent
Careful with:
Patients with CV conditions: uncompensated heart failure, cardiac arrhythmias
Hypokalemia
Hypomagnesemia
Bradycardia
Use of medications that prolong the QT interval
Janicak, P G., Marder S R., and. Pavuluri M N. Principles and Practice of Psychopharmacotherapy. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2010.

17. Ziprasidone – Clinical Profile
Very low risk of inducing weight gain
Patients who are overweight or have metabolic disturbances
Dose dependent sedation
Janicak, P G., Marder S R., and. Pavuluri M N. Principles and Practice of Psychopharmacotherapy. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2010.

18. Aripiprazole – Binding Profile
Partial D2/D3 agonist (pre and postsynaptic receptors)
5HT2A antagonist
5HT1A partial agonist
Modest affinity for H1, M1 and a 1 receptors
Tasman, A; Lieberman, J; Key, J; Maj, M. Psychiatry. 3rd ed. John Wiley & Sons, 2008
Schatzberg, AF, Nemeroff, CB. The American Psychiatric Publishing Textbook of Psychopharmacology. 4th ed.American Psychiatric Publishing, 2009

19. Aripiprazole – Prescribing Facts
Dosage range:
15-30 mg/day
Dosage forms:
Tablets: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg
Orally disintegrating tablets: 10 mg, 15 mg
Oral solution: 1mg/ml
Injection: 9.75 mg/1.3 ml
Stahl, S M. The Prescriber's Guide. 4thd ed. New York: Cambrigde University Press; 2011

20. Aripiprazole – Clinical Profile
Approved as adjunctive treatment for MDD
Low risk of causing weight gain
Akathisia is a possibility