Essentials of Psychiatry in Primary Care: Behavioral Health in the Medical Setting >Psychotic Disorders

Robert C. Smith, Gerald G. Osborn, Francesca C. Dwamena, Dale D'Mello, Laura Freilich, Heather S. Laird-Fick+
Table 9-6.Antipsychotics and Side-Effect Profile

Target Dose (mg/d) Metabolic Effecta EPS PRL Sedation Anticholinergic Hypotension

Quetiapine XR
300-800 ++ +/– – +++ + +++
Seroquel XR

Risperidoneb
4-6 ++ ++ +++ ++ – ++
Risperdal

Aripiprazole
10-30 + + – + – +
Abilify

Ziprasidonec
160 + + + ++ – +
Geodon

Olanzapine
10-20 +++ + + ++ ++ +/–
Zyprexa

Clozapined
300-450 +++ + + ++ ++ ++
Clozaril

EPS = extrapyramidal syndrome; PRL = prolactin.

aObtain fasting blood sugar at baseline, 12 weeks, and yearly.
bMay have marked prolactin increase; if clinical suspicion, obtain levels.
cMay prolong QTc (corrected QT interval on baseline ECG); if rises above >500 milliseconds, discontinue medication.
dSevere myeloid suppression and neutropenia potential: absolute neutrophil count weekly for first 6 months, biweekly for next 6 months, monthly thereafter (see text). Seizures are frequent at doses exceeding 600

mg/day.

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