Psychiatria pre prax 1/2009

Treatment with atypical antipsychotic drugs and their selection based on the spectrum of side effects

The introduction of second-generation antipsychotics into clinical practice has significantly improved the treatment of schizophrenia. When selecting a particular drug, however, its side-effect profile has to be considered in addition to affecting the targeted symptoms. The main side effects of first-generation antipsychotics include extrapyramidal side effects and hyperprolactinaemia which, along with obesity, hyperglycaemia, hyperlipidaemia, or cardiac complications, are considered to be the major risks associated with the treatment with second-generation antipsychotics. The physician must carefully assess the benefit as well as possible risks related to the side effects of the antipsychotic selected. The selection of a suitable antipsychotic must therefore be strictly individual, taking into account the benefit on the one hand and the possible risks on the other.

Keywords: antipsychotics, diabetes, dyslipidaemia, weight, metabolic syndrome, prolactin