Second generation antipsychotics for schizophrenia: SECOND GENERATION ANTIPSYCHOTICS(5)


Risperidone is associated with fewer EPSs than the conventional agents, haloperidol in particular. Its side effect profile differs from that of the other second generation agents. It does not block muscarinic receptors and, consequently, the rates of anticholinergic side effects, including confusion, are relatively low. Its most common adverse effects include anxiety, agitation, insomnia, headache and weight gain. buy flovent inhaler

Transient orthostatic hypotension and reflex tachycardia are likely a result of blockade at adrenergic receptors. At higher doses (ie, greater than 6 mg/day) the predominance of 5-HT2 blockade over D2 is diminished, and its pharmacological effects begin to resemble those of conventional agents, including the development of EPS and elevated prolactin concentrations . Prolactin elevation can result in galactorrhea, amenorrhea and decreased libido . Occasionally, EPS and serum prolactin elevations may also be apparent at low doses. Risperidone’s long term risk for TD is presumed to be lower than that with conventional antipsy-chotics. However, ongoing long term comparative studies evaluating TD risk have yet to be published. Anecdotal cases of TD have been reported.

There has been a recent trend to dosing risperidone once daily, which is reasonable based on its half-life of approximately 24 h. Twice-daily dosing was initially used in clinical trials to minimize the potential risk of orthostatic hypotension. Once daily administration has been shown to be similar in efficacy and safety to twice daily dosing at 4 to 8 mg/day and may improve compliance.

This entry was posted in Antipsychotics and tagged Clozapine, Olanzapine, Risperidone, Schizophrenia, Ziprasidone.