Selecting Atypical Antipsychotic-Practical Issues

Overview

Nowadays, we have at our disposal several atypical antipsychotics (antipsychotic of 2nd generation).There is a difference between them in the profi le of side-effects. The article focuses on side effects,which are important for selecting atypical antipsychotic. Every patient who is a candidate foratypical antipsychotic must be assessed for his/her medical susceptibilities. In more detail theweight gain, abnormalities in glucose and lipid metabolism and hyperprolactinemia are discussed.Clozapine and olanzapine appear to show the highest impact on weight gain and glucose and lipidlevels, risperidone and amisulpride on prolactin levels. On the base of current knowledge duringclozapine and olanzapine administration it is advisable to monitor blood glucose and lipid levelsat regular periods. During risperidone and amisulpride administration it is necessary to search forprolactin-dependent side affects. If present, the prolactin level should be obtained. The possibilitiesof prevention and treatment of side effects mentioned are presented. General guidelines whichshould be maintained when selecting atypical antipsychotic are suggested.

Key words:
atypical antipsychotic, side effects, weight gain, glucose intolerance, dyslipidemia,hyperprolactinemia.