Antipsychotics: Side Effects

Atypical antipsychotics

-Pine and -done groups.

-Pine group.

• Clozapine
• Olanzapine
• Quetiapine

-Done and -azole group.

• Risperidone (Risperdal)
• Ziprazidone (Geodon)
• Lurasidone (Latuda)
• Aripiprazole

The difference between dystonia, dyskinesia, akinesia, bradykinesia, Akathisia.

The motor side effects of antipsychotics can be divided into 5 categories.

1. Dystonias
2. Parkinsonism
3. Akathisia
4. Withdrawal dyskinesias
5. Tardive dyskinesias

• Dopamine is a vasopressor. We use it to raise blood pressure in patients with shock. Something that blocks dopamine will hypotension, which is one of the side effects of antipsychotics.
• Dopamine as a vasopressor has different effects that vary based on the dosing rate. It has effects on the heart and SVR as the dose increases.
• In Parkinson’s disease, brain cells, especially in the substantia nigra, don’t produce enough dopamine. There is a lack of dopamine. When you use medications like the antipsychotics that block dopamine, you get Parkinsonism (or the symptoms of Parkinson’s disease) as side effects.

Comparative Risk of Adverse Effects of Antipsychotic Medications*

ADVERSE EFFECT	Second Generation Antipsychotics
	CLOZAPINE	OLANZAPINE	QUETIAPINE	RISPERIDONE	ZIPRASIDONE	ARIPIPRAZOLE
Anticholinergic effects	+++	+	+	0	0	0
Dyslipidemia	+++	+++	++	+	0	0
Extrapyramidal symptoms	0	+	0	++	+	+
Hyperprolactinemia	0	+	0	+++	+	0
Neuroleptic malignant syndrome	+	+	+	+	+	+
Postural hypotension	+++	+	++	++	+	+
Prolonged QT interval	+	+	+	+	++	+
Sedation	+++	++	++	+	+	+
Seizures	+++	+	+	+	+	+
Sexual dysfunction	+	+	+	++	+	+
Type 2 diabetes mellitus	++	++	+	+	+	+
Weight gain	+++	+++	++	++	0	0

note: 0 = rare; + = lower risk; ++ = medium risk; +++ = higher risk.

 

Source: CMAJ June 21, 2005 172 (13) 1703-1711

 

CMAJ June 21, 2005 172 (13) 1703-1711