Dose limiting side effects of the second generation antipsychotics
What are the main dose limiting side effects of the second-generation (atypical) antipsychotics (SGAs)?
Sedation (especially with clozapine, quetiapine, olanzapine, asenapine) and extrapyramidal symptoms (e.g., akathisia, dystonia, parkinsonism; especially for risperidone, asenapine, lurazidone) are common dose-limiting side effects of SGAs.
Anticholinergic effects, orthostatic hypotension, and seizures are a concern with increasing clozapine dose.
Metabolic effects of SGAs (e.g., weight gain, dyslipidemia, hyperglycemia, and potentially diabetes) may be present at any dose and result in significant morbidity.
The rare but potentially lethal agranulocytosis that can be induced by clozapine is also possible at any dose and necessitates the close monitoring involved with the use of this drug.
