How and when to treat the most common adverse effects of antipsychotics: Expert review from research to clinical practice

Acta Psychiatr Scand. 2021 Feb;143(2):172-180. doi: 10.1111/acps.13266. Epub 2020 Dec 26.

Abstract

Objective: As most treatment guidelines for antipsychotics focus on clinical efficacy, we will instead focus on adverse effects and how to manage them. In this review, we aim to provide an up-to-date clinical resource for providers who prescribe antipsychotics and have included here "what's new" and "what to do" for numerous antipsychotic-induced adverse effects.

Methods: A review was performed of relevant literature, studies, randomized clinical trials, and systematic reviews. This information was combined with the clinical experience of the authors to formulate a practical guide for treating adverse effects of antipsychotics with an emphasis on metabolic and movement disorder adverse effects and brief mention of some others (sedation and sexual dysfunction).

Conclusions: Antipsychotics are an integral part of psychiatric care and are often prescribed lifelong. When choosing an antipsychotic, special consideration must be given to adverse effects which have an undeniable impact on quality of life and can often be the deciding factor in patients' medication compliance. While patients may respond well to one specific medication, they may still experience adverse effects that lead them to discontinue it or switch to a more tolerable but less effective option. However, strategies do exist for managing and treating adverse effects, especially metabolic and movement adverse effects, allowing better personalization of antipsychotic choice.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents* / adverse effects
  • Humans
  • Quality of Life
  • Treatment Outcome

Substances

  • Antipsychotic Agents