Side effects of typical antipsychotics
The side effects of typical antipsychotics include:
- Movement disorders
- Endocrine effects
- Sedation
Movement disorders:
- Movement Disorders also called Extrapyramidal Symptoms
- Caused by Blockage of Dopamine receptors in Nigrostriatal tract
Acute dystonia:
- Earliest Side Effect.
- Sudden contraction of a grp. of muscles [torticollis, trismus, deviation of eye]
- Mgt – I/V Anticholinergics [benztropine, promethazine, diphenhydramine]
- To prevent acute dystonia prophylactic use of anticholinergics suggested
Acute akathisia:
- Most common Side Effect.
- Inner sense of restlessness along with objective observable movements like fidgeting, pacing
- Mgt – Beta Blockers [DOC] such as propranolol, anticholinergics and benzodiazepines
Drug Induced Parkinsonism:
- Triad of Rigidity, bradykinesia and Resting Tremors
- T/T – Anticholinergics. Prophylactic Anticholinergics can be used to prevent it
Tardive dyskinesia:
- Develops after prolonged exposure [Tardive]
- Involuntary movements of tongue [twisting, protusion], jaw [Chewing], lips [smacking, puckering]
- Movement can be rapid jerky [Choreiform] or slow sinusoidal [athetoid]
Neuroleptic malignant disorder:
- Potentially fatal side effect
- Muscle Rigidity, Elevated Temperature, Increased CPK Levels, Leukocytosis and deranged LFT
- Other Symptoms – diaphoresis, tremors, confusion, autonomic disbalance
- D2 Receptors in corpus striatum [Muscle Contraction] and in Hypothalamus [Temperature regulation]
- Mgt – Dantrolene and Dopamine agonists like amantadine and bromocriptine + Supportive measures
Endocrine side effects:
- Due to blockage of tubero-infundibular tracts
- Hyperprolactemia causing galactorrhea, menstrual disturbance [Female] and impotence [Males]
- Movement can be rapid jerky [Choreiform] or slow sinusoidal [athetoid]
Other side effects:
- Sedation
- Orthostatic Hypotension
- Anticholinergic Side Effects
