Detecting and Managing Adverse Effects of Antipsychotic Medications: Current State of Play

Psychiatr Clin North Am. 2016 Jun;39(2):275-311. doi: 10.1016/j.psc.2016.01.008. Epub 2016 Mar 28.

Abstract

Antipsychotics are some of the most frequently prescribed medications not only for psychotic disorders and symptoms but also for a wide range of on-label and off-label indications. Because second-generation antipsychotics have largely replaced first-generation antipsychotics as first-line options due to their substantially decreased risk of extrapyramidal side effects, attention has shifted to other clinically concerning adverse events associated with antipsychotic therapy. The focus of this article is to update the nonextrapyramidal side effects associated with second-generation antipsychotics. Issues surrounding diagnosis and monitoring as well as clinical management are addressed.

Keywords: Adverse effects; Antipsychotic medication; First-generation antipsychotics; Hyperlipidemia; Hyperprolactinemia; QT prolongation; Second-generation antipsychotics; Weight gain.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Dementia / complications
  • Dementia / drug therapy
  • Disease Management
  • Humans
  • Hyperlipidemias / chemically induced
  • Hyperlipidemias / complications
  • Hyperprolactinemia / chemically induced
  • Hyperprolactinemia / complications
  • Hyperprolactinemia / epidemiology
  • Long QT Syndrome / chemically induced
  • Long QT Syndrome / complications
  • Osteoporosis / chemically induced
  • Osteoporosis / complications
  • Psychotic Disorders / complications*
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / mortality
  • Risk Factors
  • Sexual Dysfunction, Physiological / chemically induced
  • Sexual Dysfunction, Physiological / complications
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunctions, Psychological / chemically induced
  • Sexual Dysfunctions, Psychological / complications
  • Sexual Dysfunctions, Psychological / epidemiology
  • Weight Gain

Substances

  • Antipsychotic Agents