Major side effects of antipsychotic drugs

Since the introduction of phenothiazines into clinical practice in 1952, over 250 million people have received these drugs for the treatment of psychotic states. In addition to the phenothiazines, five other classes of neuroleptic medications are now in use: butyrophenones, thioxanthenes, dihydroindolones, diphenylbutylpiperidines, and dibenzoxazepines. Besides their use in the treatment of psychosis, these drugs have been used in the treatment of anxiety, depression, nausea, alcoholic withdrawal, and pain, and are often administered in combination with other medications. Through the use of these drugs, many psychotic patients have been able to move back into the community, and the family physician is coming into contact with more patients on maintenance dosages of neuroleptics. He/she may wish to prescribe these drugs or may, in the treatment of a medical problem, need to prescribe other medication to an individual already receiving neuroleptics. It is important, therefore, for the family physician to be aware of the side effects of these drugs and of complications which can arise when neuroleptics are given in combination with other families of drugs.