What are the possible adverse effects of antipsychotic therapy in the treatment of schizophrenia?

Updated: Mar 16, 2018
  • Author: Frances R Frankenburg, MD; Chief Editor: Glen L Xiong, MD  more...
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Patients tend not to be very adherent to antipsychotic medications, and this may, in part, be due to their adverse effects. Patients sometimes report they feel less like themselves, or less alert, when taking these medications. One troubling possibility is that while they are used to combat psychosis and in that sense to preserve brain functioning, these medications can actually interfere with the usual processes of the brain. Indeed, some practitioners have gone so far as to call haloperidol “neurotoxic” and suggest that it not be used. However, there may be adverse neurological effects with all of the antipsychotic medications, not just the conventional ones.

For example, in an open-label 6-month pilot study in Canada, the reduction of risperidone or olanzapine dose by 50% improved cognitive function for stable patients with schizophrenia and did not lead to worsening of psychotic symptoms. [101]

The following are adverse effects typically associated with conventional antipsychotic agents and with the atypical antipsychotic risperidone at dosages higher than 6 mg/day:

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