Minimizing Side Effects From the Typical and Atypical Agents
| Type of Side Effect | Action |
|---|---|
| Cardiac problems | Use high-potency agents except pimozide (Orap) to avoid conduction abnormalities. |
| Hematological disorder | Monitor CBC weekly for the first 6 months of clozapine treatment, then biweekly for additional 6 months, and every 4 weeks thereafter. |
| Parkinsonism | Low-potency agents may minimize parkinsonism because of their built-in anticholinergic property. The same is true of clozapine. |
| Prostatic hypertrophy | Avoid low-potency agents and clozapine (Clozaril), which exert high anticholinergic effects. |
| Seizure | Avoid loxapine (Loxitane) and clozapine (Clozaril) in clients with a history of seizure. Molidone (Moban) may have lower seizure risk than other antipsychotics. |
| Pregnancy | Avoid use of low-potency agents. Increased risk of anomalies is associated with use of the phenothiazines group, including chlorpromazine (Thorazine) and thioridazine (Mellaril). High-potency agents such as fluphenazine (Prolixin), haloperidol (Haldol), trifluoperazine (Stelazine), and perphenazine (Trilafon) are associated with lower risk during pregnancy. Clozapine has been used during pregnancy without short term adverse effects on the fetus |
| Weight gain | Loxapine (Loxitane), molidone (Moban), ziprasidone (Geodon), and aripiprazole (Abilify) are associated with lower risks. |
| Sexual side effects | Clozapine (Clozaril) and quetiapine (Seroquel) are associated with lower risks. |