Antipsychotics and their Side Effects

With the remarkable expansion in the use of antipsychotics, concerns about their immediate, intermediate, and long-term adverse effects have intensified. Despite this, studies consistently show that monitoring of patients taking antipsychotics can be inadequate, haphazard, or worse. This book provides a comprehensive review of the adverse effects of this pharmacologically complex therapeutic class, covering all commonly used conventional and atypical agents. In the first section, each chapter provides background information about an adverse effect, reviews the evidence linking the effect to various antipsychotics, and provides specific detection and monitoring recommendations. The second section provides unique monitoring guides for each antipsychotic. The third section provides the clinician with a program to monitor patients over the long-term. By supporting rational treatment decisions and systematic adverse effect monitoring, Antipsychotics and their Side Effects provides the clinician with the necessary information and tools for optimizing the safe and effective long-term use of antipsychotic drugs.

Antipsychotics and their Side Effects

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ISBN-13:	9780511851872
Publisher:	Cambridge University Press
Publication date:	11/11/2010
Sold by:	Barnes & Noble
Format:	eBook
File size:	3 MB

About the Author

David M. Gardner is Associate Professor, Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Michael D. Teehan is Associate Professor, Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Foreword; Preface; Purpose, development, and limitations of Antipsychotics and their Side Effects; Guide to using Antipsychotics and their Side Effects; About the authors; About the cover; Part I. Antipsychotic Side Effects and Monitoring Implications: 1. Introduction; 2. Agranulocytosis and other blood dyscrasias; 3. Anticholinergic effects; 4. Diabetes; 5. Dyslipidemia; 6. Extrapyramidal symptoms; 7. Hepatic effects; 8. Neuroleptic malignant syndrome; 9. Obesity and weight gain; 10. Ocular effects; 11. Prolactin effects; 12. QT prolongation, arrhythmias, and sudden cardiac death; 13. Sedation and sleep disturbances; 14. Seizures; 15. Sexual dysfunction; 16. Sialorrhea; 17. Skin effects and hypersensitivity reactions; 18. Tardive dyskinesia; 19. Urinary incontinence; 20. Venous thromboembolism; 21. Vital signs; Part II. Summary Monitoring Recommendations for Individual Antipsychotics: 22. Aripiprazole; 23. Chlorpromazine; 24. Clozapine; 25. Flupenthixol; 26. Fluphenazine; 27. Haloperidol; 28. Loxapine; 29. Methotrimeprazine; 30. Molindone; 31. Olanzapine; 32. Paliperidone; 33. Pericyazine; 34. Perphenazine; 35. Pimozide; 36. Pipotiazine palmitate; 37. Quetiapine; 38. Risperidone; 39. Thioridazine; 40. Thiothixene; 41. Trifluoperazine; 42. Ziprasidone; 43. Zuclopenthixol; Part III. General Monitoring Form for Patients Taking Antipsychotics; Index.

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Editorial Reviews

Reviewer: Aaron Plattner, MD (Pine Rest Christian Mental Health Services)
Description: Using evidence-based information, the authors strive to educate clinicians about the possible side effects associated with the use of first- and second-generation antipsychotic medications as well as proper monitoring guidelines.
Purpose: With an increase in the number of antipsychotic prescriptions written in the U.S. for a wider range of psychiatric conditions, and the increase in psychiatric care provided by primary care providers, the authors aim to support clinicians by providing evidence-based information for the effective and safe use of antipsychotics for their patients.
Audience: The authors identify a wide range of clinicians who will benefit from this book, including psychiatrists, family practitioners, nurses, pharmacists, dietitians, and mental healthcare workers. The authors also indicate that although this book was not developed for patients or their families, they also may be able to benefit from it. However, it will be most helpful to prescribers of antipsychotic medications.
Features: Each of the 20 concise chapters in the first of the book's three sections focuses on a specific side effect with a recommended monitoring schedule based on the best available evidence, identification of best practices, and the clinical opinions of the authors. Chapters begin with a background section followed by the data on particular antipsychotics with side effects and conclude with specific monitoring symptoms and a monitoring schedule. Each chapter includes charts, tables, and illustrations, with references at the end. Section 2 groups all of the monitoring schedules listed in section 1 together, and section 3 merges the monitoring schedules found in sections 1 and 2 into a single general monitoring form. A companion website enables clinicians to access the form from section 3 to create additional copies and adapt it for their own needs.
Assessment: Various psychiatric pharmacology books cover the side effects of antipsychotic medications in their discussion of a particular medication, but the main focus is on the actions and uses of the medication, not on the side effects. This book differs because the side effects are the main focus. This allows readers to better understand the etiology and risks of the side effects, and thus able to make a more educated decision about which antipsychotic medication to use for their patients. The monitoring schedules are unparalleled in their simplicity and clarity. The authors correctly identify the book's limitations, most importantly the lack of data for the most effective and efficient recommendations for specific monitoring schedules as well as the fact that it does not include every potential side effect. Still, I highly recommend this as a reference when prescribing antipsychotic medication.

Doody's Review Service

'My students, in particular, enjoyed some of the background history to antipsychotic therapies. I really like the comparison tables with respect to the different agents - particularly some of the less commonly focused on side effects (e.g. ocular, derm). I have been trying to develop a comprehensive metabolic monitoring form for our patients and am very impressed with the one included in the book.' Melanie McLeod, Clinical Pharmacist, Regina Qu'Appelle Health Region
'The first section of the book is valuable as a reference for those familiar with the practice of psychiatry, or as an introduction for trainees who are becoming familiar with these compounds. Overall, the practical nature of this book makes it an excellent addition to the libraries of learners and practitioners alike.' N. D. Mitchell and S. M. Dursun, University of Alberta
'I know of no other book that covers the topic so completely, lucidly, and succinctly. It is an exceptionally praiseworthy piece of work that should be on the short list of 'must have' books for every physician, nurse, and pharmacist who deals with antipsychotic medications. I will add it to my own personal library with pleasure.' Eliot Lawrence Gardner, Chief, Neuropsychopharmacology Section, National Institute on Drug Abuse, Johns Hopkins University

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