Registration Options

Webinar Date: 08/24/2021 1:00PM central
Activity Dates: 08/24/2021 - 08/24/2024

Target Audience

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the comprehensive medication management of psychiatric and/or neurological patients, we invite you to participate in this online course.

Session Summary

Thorazine was discovered in the 1950s with the understanding that dopamine antagonism was needed for antipsychotic action. This medication and the many first- and second-generation antipsychotics that followed are effective in reducing psychotic symptoms but most approved to date have relatively high binding affinity (60-80%) to the dopamine 2 (D2) receptor thought to be needed for their efficacy.

Antagonizing these post synaptic dopamine receptors often produces distressing adverse events including extrapyramidal side effects (EPS), akathisia and hyperprolactinemia. Many newer second-generation agents have reduced these neurologic side effects by adding serotonin type 2A (5-HT2A)–receptor antagonism to D2-receptor antagonism. While lower rates of these D2 related adverse effects are seen, these adverse effects remain variable among agents. These adverse effects have contributed to early discontinuation, nonadherence, rehospitalizations and medical comorbidities.

Recently approved and emerging antipsychotic medications that have low post synaptic D2 binding or without direct dopamine modulation have lower side effect burdens than older medications. This may introduce a new generation to treatments for schizophrenia where patients may never experience some of the severe adverse events. There is a great need to provide better efficacy and side effect burdens for our patients requiring that we understand these new mechanisms and consider these "third-generation" treatments early in the course of illness in order to prevent the adverse consequences.

During this activity participants will review the pharmacologic mechanisms and adverse effects related to receptor binding of antipsychotics, understand the role of D2 related adverse effects such as extrapyramidal side effects, akathisia, and hyperprolactinemia on patient outcomes, and learn the weight related side effect liabilities of existing agents. Lastly, participants will be able to discuss the novel pharmacological properties of newer, emerging and pipeline “third-generation” antipsychotics and the benefits of these medications in avoiding or minimizing adverse effects.

Course Requirements

You will proceed through the following steps to satisfactorily complete this course:

  • Sign in (or create a FREE account).
  • Register for this course.
  • Complete the pre-test before starting the activity.
  • Review the full content of the activity and reflect upon its teachings.
  • Complete the post-test at the end of the activity no later than the closing activity date.
  • Complete the evaluation at the end of the activity.
  • If necessary, complete the post-test retest no later than the closing activity date.
  • Receive a passing grade (70%).
  • Provide the necessary details in your profile to ensure correct reporting by CPNP to CPE Monitor.
Participants in this course must complete an examination and achieve a score of 70% or greater. Up to two exam attempts are provided to each participant. Successful completion of the course also requires the completion of a course evaluation. Upon successful completion, ACPE credit is reported immediately to CPE Monitor although transcripts can be retrieved by participants online at http://cpnp.org/mycpnp/transcript/acpe.

Faculty Information and Disclosures

Christoph U. Correll, MD
Austin R. Campbell, PharmD, BCPP

View biographical information and disclosures

Learning Objectives

  1. Review the pharmacologic history, mechanisms, and adverse effects related to receptor binding of antipsychotics and the evolving history of the dopamine hypothesis for psychosis treatment.
  2. Understand the role of D2 related adverse effects such as extrapyramidal side effects, akathisia and hyperprolactinemia on patient nonadherence, discontinuation, and outcomes. Consider weight related side effect liabilities of these agents.
  3. Discuss the novel pharmacological properties of newer, emerging and pipeline "third-generation" antipsychotics and the benefits of these medications in avoiding or minimizing adverse effects and novel mechanisms beyond post-synaptic D2 blockade.

Continuing Education Credit and Disclosures

Webinar Date: 08/24/2021 1:00PM central
Activity Dates: 08/24/2021 - 08/24/2024
ACPE Contact Hours: 1
ACPE Number: 0284-0000-21-060-H01-P (Knowledge)
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPEThe College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Grant Support

This activity is supported by an educational grant from Intra-Cellular Therapies Inc.