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Hustig & Norrie,
Box 2
Common side effects of oral antipsychotic drugs

Drugs Sedation Postural hypotension Anticholinergic effects Extrapyramidal side effects Other*

Phenothiazines
Chlorpromazine +++ +++ ++ ++ Photosensitivity
Pericyazine +++ ++ +++ ++
Thioridazine +++ ++ ++ ++ Severe decrease in libido
Retinal pigmentation
Cardiotoxicity in overdose

Fluphenazine
Trifluoperazine ++ + + ++

Butyrophenones
Haloperidol + + + +++ Young men most at risk of side effects
Acute dystonic reactions

Thioxanthines
Thiothixene ++ + + +++ Slightly activating

Diphenylbutyl
Pimozide + + + +++ Sudden death due to arrhythmia at high doses
ECG monitoring of benefit

Atypical neuroleptic agents
Clozapine ++++ +++ +++ + Agranulocytosis
Weight gain
Risperidone + ++ + + Extrapyramidal symptoms increase in higher doses
Olanzapine ++ + ++ + Weight gain

*A more comprehensive discussion of side effects is available in the Psychotropic drug guidelines.

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