Addressing Side Effects From Antipsychotic Treatment in Schizophrenia

Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 02/2011; 72(2):e07. DOI: 10.4088/JCP.9101tx3c
Source: PubMed


Antipsychotic treatment of schizophrenia is associated with an array of adverse events, many of which are difficult for patients to tolerate and promote nonadherence to treatment. Serious adverse events include extrapyramidal symptoms (EPS), hyperprolactinemia, weight gain leading to metabolic syndrome, sedation, cognitive deficits, and hypotension. Clinicians need to be aware of each antipsychotic's propensity to cause these adverse events as well as strategies for avoiding or minimizing the occurrence of adverse events.

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    • "The exact mechanism for development of EPS is not fully understood, although it is generally accepted that dysfunction in dopaminergic transmission of the nigrostriatal pathway plays a key role (Glazer, 2000; Tuppurainen et al., 2010). Reduced DA transmission in the form of DA receptor blockade by antipsychotic treatment in schizophrenia is frequently manifested by the side effects of EPS and hyperprolactinemia, since dopamine exerts a potent and tonic inhibition of prolactin secretion under normal conditions (Kane, 2011). In a study of 159 patients on different medications, 27 cases (17%) of hyperprolactinemia were reported after SSRI treatment, and the occurrence was the highest for sertraline followed by paroxetine and other antidepressants (Petit et al., 2003). "
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