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Tolerability of atypical antipsychotics
1Pharmacy Department, Maudsley Hospital, London, England. maudsley.d.information@btinternet.com
Drug Safety
|March 30, 2000
Summary
Atypical antipsychotics offer fewer acute side effects like extrapyramidal symptoms (EPS). However, overall tolerability is not definitively proven superior due to other adverse effects, necessitating individualized drug selection.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Therapeutics
Background:
- Atypical antipsychotics were developed to improve upon the tolerability of older typical agents.
- Key concerns with typical antipsychotics include extrapyramidal symptoms (EPS) and tardive dyskinesia.
Purpose of the Study:
- To compare the tolerability profiles of atypical versus typical antipsychotic medications.
- To identify specific adverse effect differences that impact overall patient tolerability.
Main Methods:
- Review of clinical trial data and literature comparing atypical and typical antipsychotics.
- Analysis of adverse event profiles, including EPS, tardive dyskinesia, hyperprolactinemia, and other side effects.
Main Results:
- Atypical antipsychotics demonstrate lower rates of acute EPS compared to typical agents.
- Some atypical drugs show potential for reduced tardive dyskinesia and hyperprolactinemia, though not uniformly.
- Adverse effects such as sedation, postural hypotension, and significant body weight gain are common with certain atypical antipsychotics.
- Overall tolerability, measured by treatment withdrawal, is not consistently superior for atypical agents.
Conclusions:
- While atypical antipsychotics offer benefits in reducing acute EPS, their overall tolerability advantage is not definitively established.
- Adverse effects like weight gain and sedation can significantly impact tolerability.
- Individual patient factors and specific adverse effect profiles should guide the choice between atypical and typical antipsychotics.