Ziprasidone

Although ziprasidone may share some of the adverse effects seen with the classical antipsychotics (see Chlorpromazine), the incidence and severity of such effects may vary. Frequent adverse effects with ziprasidone include somnolence, rash or urticaria, gastrointestinal disturbances, dizziness, flu-like symptoms, hypertension, headache, agitation, confusion, and dyspnoea. Orthostatic hypotension may be a problem, particularly when starting treatment.

Schizophrenia-Negative Mode

What is going on inside the mind of an adult currently suffering from schizophrenia-negative mode? It is always hard to know what is truly “going on inside the mind” of any patient, particularly patients with psychotic disorders. Carpenter and his colleagues at the Maryland Psychiatric Research Center have further distinguished negative symptoms due to “extraneous” factors (such as depression, prolonged institutionalization or medication side effects) from negative features that are enduring “core” features of schizophrenia-the so-called deficit form of schizophrenia.

Olanzapine

A suspension of olanzapine 1 mg/mL, made by crushing olanzapine tablets and suspending the powder in a syrup-based mixture containing carboxymethylcellulose preserved with methyl hydroxybenzoate and propyl hydroxybenzoate (Guy’s Hospital paediatric base formula), was considered to be stable for 2 weeks when stored in a refrigerator. Although olanzapine may share some of the adverse effects seen with the classical antipsychotics (see Chlorpromazine), the incidence and severity of such effects may vary.

Antipsychotics and Neuroleptic Malignant Syndrome (NMS)

Are some antipsychotic drugs more prone to cause neuroleptic malignant syndrome (NMS) than others? Is olanzapine known to cause NMS as well? What else can you tell me about the possibilities that olanzapine will benefit schizophrenics? How is this drug better/worse than other choices? My husband was diagnosed with NMS last year while on Stelazine and since then has not taken any antipsychotic drugs. What would be the drug of choice if he is to try a new one? Neuroleptic malignant syndrome is a severe disorder brought on by drugs used to treat psychosis.

Chlorpromazine. Precautions. Interactions

Chlorpromazine and other phenothiazines are contra-indicated in patients with pre-existing CNS depression or coma, bone-marrow suppression, phaeochromocytoma, or prolactin-dependent tumours. They should be used with caution or not at all in patients with impaired liver, kidney, cardiovascular, cerebrovascular, and respiratory function and in those with angle-closure glaucoma, a history of jaundice, parkinsonism, diabetes mellitus, hypothyroidism, myasthenia gravis, paralytic ileus, prostatic hyperplasia, or urinary retention. Care is required in patients with epilepsy or a history of seizures as phenothiazines may lower the seizure threshold.

Clozaril Levels

I am a pharmacist who practices in a mental health hospital. We are seeing some levels of both clozapine and norclozapine that are beyond the generally accepted blood levels. My own research on the subject has indicated that 1) Clozaril level is generally equated with efficacy, norclozaril level with adverse effects, 2) the optimal ratio of Clozaril to norclozaril is 2:1, 3) if the levels are high, but the patient is doing well and is suffering from no adverse effects, then leave the dose alone, and 4) some SSRI’s and Tagamet can be used in rapid cyclers to even out the Clozaril/norclozaril ratios.