Text version of a brochure I made for

NAMI:

Managing Side-Effects of Antipsychotics

Antipsychotic Basics
If your doctor has prescribed you an antipsychotic, it could mean a variety of things. It could mean that
youve experienced moments of psychosis, or loss of touch with reality. It is also indicated in treatment
of bipolar disorder, major depressive disorder, and autism.
There are two types: typical or first generation antipsychotics and atypical or second generation
antipsychotics. Common typical antipsychotics include Haloperidol (Haldol), Loxapine (Loxitane),
Pimozide (Orap), and Thiothixene (Navane). Common atypical antipsychotics include Aripiprazole
(Abilify), Olanzapine (Zyprexa), Quetiapine (Seroquel), Risperidone (Risperdal), Clozapine (Clozaril),
and Ziprasidone (Geodon).

Weight Gain
Weight gain and crippling hunger are a very common reason people stop taking their antipsychotics. They cause
weight gain by disrupting hormones which stimulates the appetite, reduces energy levels, and causes replication of
fat cells to increase. Clozapine (Clozaril) and Olanzapine (Zyprexa) are the worst for causing weight gain, and
sometimes switching to another drug can be helpful. There has also been modest weight loss success in using
Amantadine (Symmetrel), Reboxetine (Edronax), Sibutramine (Meridia), Topiramate (Topiramate), and Metformin
(Glucophage) . Traditional weight loss methods can also be effective. Cognitive behavioral therapy (CBT), nutritional
counseling, and exercise can all lower weight even on antipsychotics.
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Sexual Dysfunction
Sexual side effects are another big reason people stop taking their antipsychotics. It can be
embarrassing, and make it difficult to maintain a healthy relationship. It is experienced in as much as
80% of people taking antipsychotics. Sexual dysfunction related to antipsychotic use is thought to be
due to elevated prolactin levels. Prolactin is a hormone best known for allowing new mothers to
produce milk, but in excess causes erectile dysfunction and loss of sexual drive. Risperidone
(Risperdal) and Haloperidol (Haldol) are the worst for this side-effect, and sometimes switching to a
drug such as Olanzapine (Zyprexa), Quetiapine (Seroquel), or Aripiprazole (Abilify) can offer relief. The
most promising treatment is adding Sildenafil (Viagra) before sexual contact. Contrary to what most

advertisements would suggest, Sildenafil (Viagra) is also effective in inducing the signs of

arousal in women as well.6 Other drugs that have shown promise include Cabergoline
(Caberlin)3, Bromocriptine (Parlodel), and Amantadine (Symmetrel).5

Feeling like a zombie

Reporting sedation, or feeling like a zombie, is not an uncommon incidence in people taking antipsychotics.
Typical antipsychotics, Quetiapine (Seroquel), Olanzapine (Zyprexa), and Clozapine (Clozaril) are the ones that are
most often linked with causing sedation. In fact, a lot of them are given at nighttime to help relieve insomnia. If
possible, taking the dose only at night time may lessen day time fogginess. Modafinil (Provigil) has been shown
effective in improving cognition and decreasing grogginess. It does cause increased psychosis in 6% of patients, so
be sure to discuss pros and cons with your doctor. Some evidence shows caffeine may be effective, but it can also
cause psychosis and mania so do never self-dose.
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A Final Word...
The most important thing to remember when taking an antipsychotic is to keep an open line
of communication with your doctor. You may experience negative side-effects, but most of
them can be controlled if your doctor is aware. Never stop taking your antipsychotic without
talking to your doctor first, as stopping them abruptly can have serious effects such as flulike symptoms, anxiety, insomnia, electric shock-like pains, and return of the symptoms that
the drug was treating.2

References

1. Baptista, T., ElFakih, Y., Uzctegui, E., Sandia, I., Tlamo, E., Araujo de Baptista, E., & Beaulieu, S. (2008).
Pharmacological management of atypical antipsychotic-induced weight gain. CNS Drugs, 22(6), 477-495 19p.
2. Howland, R. (2010). Potential adverse effects of discontinuing psychotropic drugs. Part 3: Antipsychotic, dopaminergic, and
mood-stabilizing drugs. Journal Of Psychosocial Nursing & Mental Health Services, 48(8), 11-14 4p.
doi:10.3928/02793695-20100708-01
3. Kalkavoura, C. S., Michopoulos, I., Arvanitakis, P., Theodoropoulou, P., Dimopoulou, K., Tzebelikos, E., & Lykouras, L.
(2013). Effects of cabergoline on hyperprolactinemia, psychopathology, and sexual functioning in schizophrenic patients.
Experimental & Clinical Psychopharmacology, 21(4), 332-341 10p. doi:10.1037/a0033448
4. McIntyre, R. (2009). Review: non-pharmacological interventions reduce antipsychotic induced weight gain. Evidence
Based Mental Health, 12(2), 52-52 1p. doi:10.1136/ebmh.12.2.52
5. Nagaraj, A., Pai, N., & Rao, S. (2009). Antipsychotics and sexual dysfunction: Sexual dysfunction: Part III. Online Journal
of Health and Allied Sciences, 8(3).
6. Park, Y. W., Kim, Y., & Lee, J. H. (2012). Antipsychotic-Induced Sexual Dysfunction and Its Management. The World
Journal of Mens Health, 30(3), 153159. http://doi.org/10.5534/wjmh.2012.30.3.153
7. Pierre, J. (2009). Adjunctive Modafinil may improve cognition in schizophrenia patients. Brown University
Psychopharmacology Update, 20(2), 1-6 4p.
8. Usher, K., Park, T., & Foster, K. (2013). The experience of weight gain as a result of taking second-generation antipsychotic
medications: the mental health consumer perspective. Journal of Psychiatric & Mental Health Nursing, 20(9), 801-806
6p. doi:10.1111/jpm.12019
9. Vreeland, B., Minsky, S., Menza, M., Radler, D., Roemheld-Hamm, B., & Stern, R. (2003). A program for managing weight
gain associated with atypical antipsychotics. Psychiatric Services, 54(8), 1155-1157 3p.
10. Wesensten NJ, Belenky G, Kautz MA, Thorne DR, Reichardt RM, Balkin TJ. Maintaining alertness and performance
during sleep deprivation: Modafinil versus Caffeine. Psychopharmacology (Berl). 2002;159(3):238-247.