APs and ADRs [from red-text lists only!!!]

APs associated with sedation?

clozapine > quetiapine > olanzapine = chlorpramazine = thioridazine > mid-potency FGAs > risperidone

APs associated with orthostatic hypotension?

clozapine > chlorpramazine = thioridazine > loxapine > lurasidone = iloperidone = mid-potency FGAs

APs associated with anticholinergic reactions?

clozapine, mainly

[Severe constipation from clozapine (paralytic ileus, bowel obstruction) can lead to death!!!]

APs associated with decreased seizure threshold?

clozapine > olanzapine = risperidone = quetiapine > chlorpromazine > fluphenazine = haloperidol = perphenazine = thioridazine

[‘Chlaus, on Risp Queen, clarified, “Floof, hallo per Thio.”’]

[Avoid clozapine levels >500 ug/L!]

APs associated with agranulocytosis?

Clozapine

[Risk greatest in first 3 months especially, but up to 1 year after starting]

[Risk factors: female, older, taking multiple psychotropic medicines]

APs associated with cardiac toxicity?

Thioridazine causes longest QT prolongation

Aripiprazole observed to decrease QT — makes it a good drug for patients with prolonged QT who need an antipsychotic

APs associated with myocarditis?

clozapine, mainly

[Nonspecific eosinophilia (too many eosinophils) has been noticed in some cases of clozapine-induced myocarditis!!]

APs associated with hyperprolactinemia?

risperidone and paliperidone > FGAs

[Aripiprazole and brexpiprazole lower prolactin secretion — GOOD!!!!]

APs associated with weight gain?

clozapine > olanzapine > quetiapine > risperidone

[Risk factors: young, antipsychotic naive, low BMI (someone with higher BMI likely won’t see much weight gain from APs), polypharmacy]

APs associated with glucose intolerance?

clozapine = olanzapine > quetiapine = risperidone

[Adult-onset diabetes 2x more prevalent in those with schizo (most of whom are treated with APs)]

APs associated with lipid abnormalities?

clozapine = olanzapine > quetiapine

[Mostly triglyceride changes]

[Statins can be used to treat but risk vs. benefit consideration with DDIs]