Therapeutic: antipsychotics, mood stabilizers
Schizophrenia. Acute and maintenance therapy of manic and mixed episodes associated with bipolar disorder (as monotherapy or with lithium or valproate). Adjunct treatment of depression in adults. Agitation associated with schizophrenia or bipolar disorder.
Psychotropic activity may be due to agonist activity at dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at the 5-HT2A receptor. Also has alpha1-adrenergic blocking activity. Therapeutic Effects: Decreased manifestations of schizophrenia; Decreased mania in bipolar patients; Decreased symptoms of depression. Decreased agitation associated with schizophrenia or bipolar disorder.
Adverse Reactions/Side Effects
CNS: akathisia, confusion, depression, drowsiness, extrapyramidal reactions, fatigue, hostility, insomnia, lightheadedness, manic reactions, impaired cognitive function, nervousness, restlessness, seizures, suicidal thoughts, tardive dyskinesia. Resp: dyspnea. CV: bradycardia, chest pain, edema, hypertension, orthostatic hypotension, tachycardia. EENT: blurred vision, conjunctivitis, ear pain. GI: constipation, anorexia, ↑ salivation, nausea, vomiting, weight loss. GU: urinary incontinence. Hemat: anemia. Derm: dry skin, ecchymosis, skin ulcer, sweating. MS: muscle cramps, neck pain. Metab: hyperglycemia. Neuro: abnormal gait, tremor. Misc: NEUROLEPTIC MALIGNANT SYNDROME, ↓ heat regulation.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Monitor and report signs of neuroleptic malignant syndrome, including hyperthermia, diaphoresis, generalized muscle rigidity, altered mental status, tachycardia, changes in blood pressure (BP), and incontinence. Symptoms typically occur within 4–14 days after initiation of drug therapy, but can occur at any time during drug use.
Be alert for new seizures or increased seizure activity, especially at the onset of drug treatment. Document the number, duration, and severity of seizures, and report these findings immediately to the physician.
Assess motor function, and be alert for extrapyramidal symptoms. Report these symptoms immediately, especially tardive dyskinesia, because this problem may be irreversible. Common extrapyramidal symptoms include:
Tardive dyskinesia (uncontrolled rhythmic movement of mouth, face, and extremities, lip smacking or puckering, puffing of cheeks, uncontrolled chewing, rapid or worm-like movements of tongue).
Pseudoparkinsonism (shuffling gait, rigidity, tremor, pill-rolling motion, loss of balance control, difficulty speaking or swallowing, mask-like face).
Akathisia (restlessness or desire to keep moving).
Other dystonias and dyskinesias (dystonic muscle spasms, twisting motions, twitching, inability to move eyes, weakness of arms or legs).
Be alert for suicidal thoughts and ideology. Notify physician immediately if patient exhibits signs of depression or other changes in mood and behavior such as nervousness, restlessness, hostility, confusion, or manic reactions.
Assess levels of drowsiness or lightheadedness, especially in older adults. Determine if these side effects might impair gait, balance, and other functional activities.
Monitor signs of anemia, including unusual fatigue, shortness of breath with exertion, bruising, and pale skin. Notify physician immediately if these signs occur.
Assess BP, and report a sustained increase in BP (hypertension) or a fall in BP ...
Log In to View More
If your institution is currently a subscriber
of the F.A. Davis PT Collection please sign in below.
If your institution is not a subscriber
please click here
to learn more.
Want remote access to your institution's subscription?
Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.
If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.