Antipsychotics relative side effects

Relative Side-Effect Incidence of Commonly Used Antipsychotics" ... 

B.l Common antipsychotics - approximate relative side effect profiles Appendix C Alcohol and drugs Appendix D Cognitive testing Appendix E Mental health legislation Appendix F Useful contacts Index... 

Table B.1.1 Oral antipsychotics - approximate relative side effects...

See Appendix B(l-3) for relative side effect profiles and specific antipsychotic information. 

Risperidone (11) is a new type of an atypical antipsychotic with relatively pronounced effects on negative symptoms and low extrapyramidal side... 

Table 71-3 presents the relative incidence of common categories of antipsychotic side effects. 

Dicyclomine (Bentyl), oxybutynin (Ditropan), and tolterodine (Detrol) are nonselective smooth muscle re-laxants that produce relatively little antagonism of muscarinic receptors at therapeutic concentrations. The mechanism of relaxation is not known. Finally, some other classes of drugs can act in part as muscarinic antagonists. For example, the antipsychotics and antidepressants produce antimuscarinic side effects (e.g., dry mouth). 

A variety of relatively uncommon dermatological side effects have been noted to be associated with antipsychotic agents. These include maculopapular rashes, urticaria, and erythema multiforme (Arana, 2000). Photosensitivity and skin pigmentation can also occur during treatment with these drugs. Although skin pigmentation has been most frequently reported with chlorpromazine, this can occur with thioridazine and trifluoperazine (Harth and Rapoport, 1996). In addition, treatment-induced alopecia has been reported for haloperidol, olanzapine, and risperidone (Mercke et ah, 2000). 

At present, however, extrapyramidal side effects continue to be one of the major drawbacks of antipsychotic medications. The primary types of extrapyramidal side effects, the manifestations of each type, and the relative time of their onset are shown in Figure 8-2. Some factors involved in patient susceptibility and possible treatment of these side effects are discussed here. 

FIGURE 8-2 Extrapyramidal side effects and their relative onset after beginning antipsychotic drug therapy. 

All three compounds have relatively high affinity to serotonin 5-HT2B receptors, and clozapine and olanzapine also have remarkable affinity to 5-HT6 and 5-HT7 receptors, but almost nothing is known of the role of these interactions either in the antipsychotic action or in the side effects. 

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