Atypical antipsychotics

Atypical antipsychotics

Atypical antipsychotics should now be used first-line in patients with schizophrenia, according to 2005 NICE guidelines. The main advantage of the atypical agents is a significant reduction in extrapyramidal side-effects.


Adverse effects of atypical antipsychotics

• weight gain
  Atypical antipsychotics commonly cause weight gain
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  Importance: 65
• clozapine is associated with agranulocytosis
  agranulocytosis
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  (see below)
• hyperprolactinaemia
  hyperprolactinaemia
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The Medicines and Healthcare products Regulatory Agency has issued specific warnings when antipsychotics are used in elderly patients:

• increased risk of stroke
  Antipsychotics may cause increased risk of ischaemic stroke
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  Importance: 1
• increased risk of venous thromboembolism
  Antipsychotics may cause increased risk of venous thromboembolism
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  Importance: 99

Examples of atypical antipsychotics

• clozapine
• olanzapine: higher risk of dyslipidemia and obesity
  Olanzapine has a higher risk than other atypicals for dyslipidemia and obesity
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  Importance: 70
• risperidone
• quetiapine
• amisulpride
• aripiprazole
  aripiprazole
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  : generally good side-effect profile, particularly for prolactin elevation

+PassMedicine Notes

Atypical antipsychotics should now be used first-line in patients with schizophrenia, according to 2005 NICE guidelines. The main advantage of the atypical agents is a significant reduction in extrapyramidal side-effects.

Adverse effects of atypical antipsychotics

• weight gain
• clozapine is associated with agranulocytosis (see below)
• hyperprolactinaemia

The Medicines and Healthcare products Regulatory Agency has issued specific warnings when antipsychotics are used in elderly patients:

• increased risk of stroke
• increased risk of venous thromboembolism

Examples of atypical antipsychotics

• clozapine
• olanzapine: higher risk of dyslipidemia and obesity
• risperidone
• quetiapine
• amisulpride
• aripiprazole: generally good side-effect profile, particularly for prolactin elevation