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A Review of Common Antipsychotics

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By Rosanna Sutherby, PharmD

Antipsychotics are medications used to treat psychosis associated with mental illnesses, such as schizophrenia and bipolar disorder. Other names for antipsychotics include neuroleptics and major tranquilizers.

More Than Just Treatment for Bipolar Disorders

Antipsychotics are divided into two classes. First-generation (typical) antipsychotics were developed in the 1950s and have been associated with unpleasant side effects, such as involuntary movements, repetitive motions, or inability to move. Second-generation (atypical) antipsychotics were developed in the 1980s, and they are generally less likely to cause movement-related side effects. However, you should be aware of other side effects and precautions if you take these newer drugs.

The following is a review of commonly prescribed second-generation antipsychotics.

Abilify (aripiprazole)

Abilify (aripiprazole) works by regulating chemicals, such as dopamine and serotonin, in your brain. Abilify is used alone or in combination with other medications to treat the following conditions:

  • Schizophrenia
  • Manic and mixed episodes of bipolar disorder
  • Depression
  • Irritability associated with autism
  • Tourette’s syndrome

The following are common side effects associated with Abilify:

  • Difficulty with speech
  • Problems with balance
  • Nausea
  • Vomiting
  • Dizziness
  • Anxiety or restlessness
  • Drooling
  • Stiffness
  • Trembling
  • Shuffle walk
  • Uncontrolled movements of the face, neck, and back

This is not a complete list of side effects. Talk to your doctor or pharmacist to learn more about the side effects of this medication.

Abilify may increase thoughts of suicide in some people. Immediately let a healthcare provider of caregiver know if you feel depressed or have thoughts of hurting yourself.

Abilify may add to the drowsiness effects of other medications or substances that make you sleepy or decrease alertness. If you are taking Abilify, check with your doctor or pharmacist before taking any drugs that may cause drowsiness, including the following:

  • Alcohol
  • Antihistamines
  • Sleeping medications
  • Medications for anxiety
  • Muscle relaxants
  • Prescription pain medicine

This is not a complete list of drug interactions for Abilify. Talk to your pharmacist about interactions between Abilify and other medicines that you take.

Seroquel (quetiapine)

Seroquel (quetiapine) is an atypical antipsychotic that works by regulating dopamine and serotonin in your brain. It is used alone or with other medications to treat the following:

  • Schizophrenia
  • Depression
  • Manic and depressive episodes of bipolar disorder
  • Obsessive-compulsive disorder (OCD)

The most common side effects seen with Seroquel include the following:

  • Drowsiness
  • Dry mouth
  • Dizziness
  • Constipation
  • Weight gain
  • Muscle weakness
  • Abdominal pain
  • Chills
  • Confusion
  • Postural hypotension (drop in blood pressure when you get up quickly from a lying or sitting position)

Seroquel may increase blood sugar levels. Talk to your doctor if you notice increased thirst or increased urination. If you have diabetes, make sure to monitor your blood sugar levels closely while taking Seroquel.

Seroquel may increase thoughts of suicide in some people. Immediately let a healthcare provider of caregiver know if you feel depressed or have thoughts of hurting yourself.

Seroquel may have other side effects. A conversation with your doctor or pharmacist will help you understand other side effects you may experience while taking this medicine.

You should not mix Seroquel with other medications that may cause drowsiness, such as:

  • Alcohol
  • Antihistamines
  • Sleeping medications
  • Medications for anxiety
  • Muscle relaxants
  • Prescription pain medicine

Seroquel interacts with drugs that are processed through your liver. Talk to your pharmacist about possible drug interactions between Seroquel and other medications you are taking.

Risperdal (risperidone)

Risperdal works by regulating dopamine and serotonin in your brain. It is a second-generation antipsychotic used alone or in combination with other drugs to treat the following conditions:

  • Schizophrenia
  • Manic and mixed episodes of bipolar disorder
  • Irritability associated with autism
  • Tourette’s syndrome

Common side effects of Risperdal include the following:

  • Drowsiness
  • Tiredness
  • Sore throat
  • Runny nose
  • Shaking
  • Dizziness
  • Anxiety
  • Aggressive behavior
  • Nausea
  • Vomiting
  • Stomach pain or discomfort
  • Problems with vision
  • Shuffle walk
  • Memory problems
  • Problems with balance
  • Constipation
  • Dry mouth
  • Weight gain

Immediately let your doctor know if you experience any of the following symptoms while taking Risperdal:

  • Seizures
  • Trouble breathing
  • Rapid heartbeat
  • High fever
  • Changes in blood pressure
  • Excessive sweating
  • Loss of bladder control
  • Muscle stiffness
  • Abnormally pale skin

These may be symptoms of a life-threatening reaction known as neuroleptic malignant syndrome (NMS) and requires immediate medical attention.

Risperdal may increase your blood sugar levels. Let your healthcare provider know if you notice increased thirst or increased urination.

Medications that affect your central nervous system may worsen some side effects of Risperdal. Talk to your doctor or pharmacist before taking any drugs that may cause drowsiness or affect concentration, including the following:

  • Alcohol
  • Antihistamines
  • Sleeping medications
  • Medications for anxiety
  • Muscle relaxants
  • Prescription pain medicine
  • Seizure medication
  • Antidepressants

This is not a comprehensive list of side effects or drug interactions for Risperdal. Always discuss your medicines with your pharmacist to understand potential side effects and drug interactions.

Geodon (ziprasidone)

Geodon is an atypical antipsychotic that works by regulating dopamine and serotonin in your brain. It is used alone or in combination with other medications to treat the following:

  • Schizophrenia
  • Manic and mixed episodes of bipolar disorder
  • Tourette’s syndrome

Common side effects of Geodon include the following:

  • Cough
  • Problems with speech
  • Restlessness
  • Problems with balance
  • Fear or anxiety
  • Shuffle walk
  • Stiffness
  • Trembling
  • Uncontrolled movements of the face, neck, and back
  • Sore throat
  • Fever

Like Risperdal, Geodon can cause NMS. Immediately let your doctor know if you experience any of the symptoms of NMS discussed above.

Geodon may cause dangerous changes in your heart rhythm, especially if combined with other medications that may affect your heart rhythm, including the following:

  • amiodarone (Cordarone)
  • azithromycin (Zithromax)
  • levofloxacin (Levaquin)
  • moxifloxacin (Avelox)
  • chlorpromazine (Thorazine)
  • dofetilide (Tikosyn)
  • sotalol (Betapace)
  • tacrolimus (Prograf)
  • pimozide (Orap)
  • thioridazine (Mellaril)

This is not a complete list of side effects or drug interactions for Geodon. Always discuss your medications with your pharmacist to understand potential side effects and drug interactions.

Be sure to compare prescription prices before filling your medication. You can use a free Rx savings card to get the lowest prescription price at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.ncbi.nlm.nih.gov/books/NBK84635/

https://www.wellrx.com/abilify/drug-information/

https://www.wellrx.com/seroquel/drug-information/

https://www.wellrx.com/risperdal/drug-information/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726098/#:~:text=Neuroleptic%20malignant%20syndrome%20(NMS)%20is,muscle%20rigidity%2C%20and%20autonomic%20dysfunction.

https://www.wellrx.com/geodon/drug-information/

https://www.wellrx.com/https://www.wellrx.com/prescriptions/

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