Antipsychotics somnolence

A metaanalysis showed that 17% to 18% of dementia patients showed a modest treatment response to atypical antipsychotics. Adverse events included somnolence, extrapyramidal symptoms, abnormal gait, worsening cognition, cerebrovascular events, and increased risk of death. 

Data from short-term clinical trials (6 weeks) suggest that quetiapine may be useful for the management of psychotic disorders in patients who do not tolerate the adverse effects of the typical antipsychotic drugs or clozapine (3). The most common adverse effects of quetiapine were dizziness, hypotension, somnolence, and weight gain. Raised hepatic enzymes have also been reported. In addition, two patients with idiopathic Parkinson s disease and psychosis were treated with quetiapine for 52 weeks (4). Psychotic symptoms were successfully controlled without worsening of motor disability. 

DOT CLASSIFICATION 6.1 Label Poison SAFETY PROFILE Poison by ingestion, inhalation, subcutaneous, intravenous, and intraperitoneal routes. Toxic effects resemble strychnine poisoning. Human systemic effects by inhalation somnolence, convulsions, and antipsychotic effects. Human central nervous system effects by inhalation. When heated to decomposition it emits highly toxic fumes of NOx. 

Until the advent of the atypical antipsychotics, conventional agents were widely used, although available placebo-controlled studies suggested that they were moderately effective at best. More recently, risperidone has been shown to have modest effects in patients with psychotic symptoms or behavioral disturbances associated with dementia. " It is recommended to begin with 0.25 mg daily and to titrate in 0.25- to 0.5-mg increments to 1 mg daily, which is usually considered the optimal dose. If response is inadequate, further titrating to a maximum of 2 mg daily may be necessary if the patient is tolerating the medication however, side effects, particularly extrapyramidal effects, somnolence, and orthostasis, increase with increased dose. 

Toxicology LD50 (oral, rat) 23,160 mg/kg, (IP, rat) > 1 g/kg, (IV, mouse) 1530 mg/kg harmful by inh., skin contact danger of cumulative effects may cause somnolence, muscle weakness, ataxia, convulsions, antipsychotic behavior, changes in liver/kidney/spleen wt. suspected carcinogen tumorigen mutagen TSCA listed... 

Toxicology LD50 (oral, mouse) 176 mg/kg, (IP, mouse) 115 mg/kg very toxic harmful by inh., ing., skin contact irritating to eyes, skin, respiratory system may cause somnolence, antipsychotic behavior, fatty liver degeneration TSCA listed Precaution Incompat. with strong oxidizing agents... 

Nervous system A study comparing somnolence with asenapine, olanzapine, risperidone and haloperidol relative to placebo evaluated 10 clinical trials of patients with schizophrenia or bipolar disorder [36 -]. The duration and incidence of somnolence was greatest for asenapine and olanzapine (maximal for olanzapine) and with shorter time to onset than the other antipsychotics and placebo patients with bipolar disorder were the most sensitive. 

In a 4-week, randomised, open-label comparison of ziprasidone and clozapine in the treatment of psychotic symptoms in Parkinson s disease, the most common initial adverse effect was somnolence [47 ]. There was no difference in movement disorder scales between the two antipsychotics. 

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