ADVERSE-EFFECTS OF ANTIPSYCHOTIC-DRUGS

Since the introduction of chlorpromazine in the 1950s, neuroleptic med ications have been the mainstay of treatment of schizophrenia and othe r psychotic disorders. These medications do not always lead to complet e remission of symptoms but they have allowed many patients to lead mo re productive and satisfying lives away from the restrictions of chron ic hospitalisation. However, neuroleptics are associated with a number of adverse effects that can compromise their effectiveness. Extrapyra midal adverse effects include acute dystonic reactions, neuroleptic-in duced Parkinsonism and akathisia. They can often be treated with neuro leptic dose reduction, addition of anticholinergic or beta-blocking ag ents, or medication change. Later-onset movement disorders such as tar dive dyskinesia or dystonia require careful evaluation and may be trea ted with dose reduction or change of neuroleptic to an atypical agent. Potentially fatal reactions such as agranulocytosis and neuroleptic m alignant syndrome can rarely occur and often require significant medic al intervention. Clozapine offers some advantages over 'typical' neuro leptics but has a unique adverse effect profile which includes agranul ocytosis.