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Second-generation antipsychotics and extrapyramidal adverse effects.

Nevena Divac1, Milica Prostran1, Igor Jakovcevski2

  • 1Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr. Subotica 1, 11000 Belgrade, Serbia.

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|July 5, 2014
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Summary
This summary is machine-generated.

Second-generation antipsychotics cause extrapyramidal symptoms, though less often than older drugs. Risk factors include drug choice, dose, and patient history, highlighting ongoing tolerability concerns.

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Area of Science:

  • Pharmacology
  • Neuroscience
  • Clinical Psychiatry

Background:

  • First-generation antipsychotics are known for extrapyramidal adverse effects.
  • Second-generation antipsychotics (SGAs) were developed with expectations of lower extrapyramidal syndrome (EPS) risk due to their atypical mechanisms.
  • This review examines current literature on SGAs and EPS.

Purpose of the Study:

  • To summarize recent literature on the incidence and severity of extrapyramidal syndrome (EPS) associated with second-generation antipsychotics.
  • To identify risk factors contributing to EPS in patients taking SGAs.

Main Methods:

  • Review of recent scientific literature comparing EPS incidence and severity between first- and second-generation antipsychotics.
  • Analysis of studies investigating risk factors for EPS with SGAs.

Main Results:

  • EPS occurs with second-generation antipsychotics, albeit at lower rates than with first-generation agents.
  • Key risk factors for EPS include specific SGA choice (e.g., clozapine lowest risk, risperidone highest), high dosages, prior EPS history, and comorbidities.
  • Comparative study outcomes are influenced by the choice of first-generation comparator drugs.

Conclusions:

  • Extrapyramidal syndrome remains a significant clinical concern despite the advent of second-generation antipsychotics.
  • Tolerability expectations for SGAs regarding EPS have not been fully realized, as incidence and severity vary among agents.