Antipsychotic agents side effects

In an additional study, fluspirilene (10), administered intramuscularly in aqueous suspension, at weekly intervals was an effective antipsychotic agent. Side effects were noted in 70-75% of the patients.The pharmacological profile was that of typical known neuroleptic compounds.A single weekly dose of fluspirilene was better or equal to a daily dose of haloperidol in 79% of schizophrenic patients. 

Given that limitation, the only ways to counteract elevated prolactin are to lower the dose of the antipsychotic or to switch to another antipsychotic that does not elevate prolactin. We prefer switching (especially if the problem has been encountered with an older style typical antipsychotic) to an atypical antipsychotic if side effects of elevated prolactin become problematic. Most atypical antipsychotics, with the exception of risperidone when used in high doses, do not elevate prolactin. There are few compelling reasons to use a typical antipsychotic compared to the newer atypical agents. 

Many of the side effects associated with antipsychotic agents can be attributed to their antagonist activity at a variety of CNS receptors, which include histamine Hi, adrenergic 01/02, cholinergic Mi receptors, serotonin 5-HT2, and dopamine D2 receptors in the brain. For example, antipsychotic drug side effects such as sedation. 

The answer is c. (Hardman, pp 414-4163) Unwanted pharmacologic side effects produced by phenothiazine antipsychotic drugs (e.g., perphenazine) include Parkinson-like syndrome, akathisia, dystonias, galactorrhea, amenorrhea, and infertility. These side effects are due to the ability of these agents to block dopamine receptors. The phenothiazines also block muscarinic and a-adrenergic receptors, which are responsible for other effects. 

The side effects of conventional antipsychotics are of even greater concern when treating chronic psychosis in a patient with dementia. With sustained administration of a typical antipsychotic, these patients will be highly vulnerable to the extrapyramidal effects of the medication, which can increase the risk for falls. Thus, atypical antipsychotics have also been rapidly accepted as first-line agents when treating... 

Aripiprazole is an atypical antipsychotic agent that is not associated with an impact on prolactin levels and is not associated with impotence as a side-effect. It may precipitate suicidal ideation as a side-effect. 

The impact of antipsychotic agents on consciousness is immediately apparent from the frequency with which sedation and drowsiness are reported as side effects (Tune et ah, 1991), a property which historically has been used as a treat-... 

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