Secondary Effects of Antipsychotics: Women at Greater Risk than Men

Mary V. Seeman


Schizophr Bull. 2009;35(5):937-948. 

In This Article

Abstract and Introduction


Context: The health burden of antipsychotic medication is well known, but the disproportionate effect on women as compared with men is underappreciated.
Objective: The goal of this article is preventive—to better inform clinicians so that the risks to women and to their offspring can be diminished.
Method: All PubMed sources in which the search term gender (or sex) was linked to a side effect of antipsychotic medication were reviewed.
Result:There is general agreement in the literature on women's increased susceptibility to weight gain, diabetes, and specific cardiovascular risks of antipsychotics, with less consensus on malignancy risks and risks to the fetus. Cardiovascular death, to which men are more susceptible than women, is disproportionately increased in women by the use of antipsychotics. Sedating antipsychotics raise the risk of embolic phenomena during pregnancy, and postpartum Prolactin-elevating drugs suppress gonadal hormone secretion and may enhance autoimmune proclivity.
Conclusions: Clinicians need to be aware of the differential harm that women (and their offspring) can incur from the side effects of antipsychotics.


A systematic PubMed search entering search terms for the various side effects of second-generation antipsychotics (blood dyscrasia, cardiovascular event, diabetes mellitus (DM), hypertension, metabolic syndrome, neuroleptic malignant syndrome, prolactin elevation, QT interval, sleep apnea, thromboembolism, and weight gain) plus "gender" and "antipsychotic" linked to "malignancy" and "birth complication" yielded a long list of publications Those with the greatest clinical relevance are examined in this article, which reviews the potential harm of antipsychotics to women and their offspring.


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