Theme: Antipsychotics (adverse effects)
Select the correct answer for each of the following
| A. | Asenapine |
| B. | Quetiapine |
| C. | Clozapine |
| D. | Olanzapine |
| E. | Pimozide |
| F. | Zuclopenthixol |
| G. | Haloperidol |
| H. | Aripiprazole |
| I. | Flupentixol |
| J. | Paliperidone |
Select the correct answer for each of the following
| NaN. | Most likely to cause symptoms such as constipation, and increased heart rate |
| Clozapine 84% These symptoms are examples of peripheral anticholinergic side-effects (central anticholinergic side-effects include symptoms such as confusion, impaired concentration, and memory impairment). Clozapine is most likely to cause anticholinergic side-effects. Although hypersalivation occurs, approximately 6% of patients complain of a dry mouth. |
| NaN. | Least likely to cause diabetes |
| Aripiprazole 84% |
| NaN. | Most likely to cause sedation |
| Clozapine 54% Clozapine causes significant sedation. |
Antipsychotics (side effects)
The main side effects of antipsychotics of listed in the table below. This is just a list of the more common side effects that come up in the exams.
| Receptor | Side effects |
|---|---|
| Antidopaminergic effects | Galactorrhoea, gynecomastia, menstrual disturbance, lowered sperm count, reduced libido, Parkinsonism, dystonia, akathisia, tardive dyskinesia |
| Anticholinergic (antimuscarinic) effects | Dry mouth, blurred vision, urinary retention, constipation |
| Antiadrenergic effects | Postural hypotension, ejaculatory failure |
| Histaminergic effects | Drowsiness |
The Maudsley Guidelines offer the following rough guide to the relative adverse effects of the antipsychotics:
| Drug | Sedation | Weight gain | Diabetes | EPSE | Anticholinergic | Hypotension | Prolactin elevation |
|---|---|---|---|---|---|---|---|
| Amisulpride | - | + | + | + | - | - | +++ |
| Aripiprazole | - | +/- | - | +/- | - | - | - |
| Asenapine | + | + | +/- | +/- | - | - | +/- |
| Clozapine | +++ | +++ | +++ | - | +++ | +++ | - |
| Flupentixol | + | ++ | + | ++ | ++ | + | +++ |
| Fluphenazine | + | + | + | +++ | ++ | + | +++ |
| Haloperidol | + | + | +/- | +++ | + | + | +++ |
| Olanzapine | ++ | +++ | +++ | +/- | + | + | + |
| Paliperidone | + | ++ | + | + | + | ++ | +++ |
| Pimozide | + | + | - | + | + | + | +++ |
| Quetiapine | ++ | ++ | ++ | - | + | ++ | - |
| Risperidone | + | ++ | + | + | + | ++ | +++ |
| Zuclopenthixol | ++ | ++ | + | ++ | ++ | + | +++ |
+++ = High incidence
++ = Moderate
+ = Low
- = Very low
