Safety and Tolerability of Second and Third Generation Antipsychotics

Overview

At first the authors deal with new antipsychotics. In the centre of interest there are new antipsychotics, often referred to as atypical or antipsychotics of the second or third generation. The atypical antipsychotics carry less risk or EPS, however, they can cause other side effects. These can be a problem, because schizophrenic patients have higher rate of morbidity and mortality from cardiovascular disease independent from treatment. These side effects include weight gain, diabetes, hyperlipidemia and QT prolongation. The published data concerning this topic are summarized. Finally the data concerning the QT prolongation in unselected population of hospitalised psychiatric patients at Brno psychiatric department are presented. The occurrence (4.1 % of patients) of abnormal QTc was lower than in the so-far available literature. This could be connected with the change of spectrum of antipsychotics used, the general trend to use lower doses of antipsychotics and prescribers increasing awareness about this phenomenon.

Key words:
second and third generation antipsychotics, extrapyramidal side effects, morbidity, mortality, prolongation of QT interval.