Clinical Pharmacology and MedicationAssociated Side Effects: A Review of Second-Generation Antipsychotics for SchizophreniaAuthor(s): Robert R. Conley, Deanna L. Kelly
Second-generation antipsychotics (SGAs) have largely replaced conventional antipsychotics as first-line therapy for the treatment of schizophrenia in the United States. While recent evidence suggests similar efficacy with low-dose conventional antipsychotics, much of the advantage favoring SGAs comes from the fact that there are less extrapyramidal side effects (EPS) at effective doses with these drugs. As a medication class, and with the exception of clozapine, the SGAs overall are very similar with regard to efficacy, yet are heterogeneous with respect to receptor binding and structure-activity as well as their side effect liabilities. This paper will review the clinical psychopharmacology of the SGAs, as well as adverse events associated with these drugs. Because certain side effects may be associated with a higher likelihood for nonadherence with treatment, more detailed data for each of the SGAs with regard to EPS, weight gain and metabolic abnormalities, and sexual dysfunction is presented.