Weight gain | Glucose abnormalities | Hyperlipidemia | Akathisia | Parkinsonism | Dystonia | Tardive dyskinesia | Prolactin elevation | Sedation | Anticholinergic | Orthostatic hypotension | QTc prolongation | |
Second-generation agents | ||||||||||||
Aripiprazole | + | + | + | ++ | + | + | + | + | + | + | + | * |
Asenapine | ++ | ++ | ++ | ++ | + | ++ | ++ | ++ | ++ | + | ++ | + |
Brexpiprazole¶ | + | + | ++ | ++ | + | + | + | + | ++ | + | + | * |
Cariprazine¶ | ++ | + | + | ++ | + | + | + | + | ++ | ++ | + | * |
ClozapineΔ | +++ | +++ | +++ | + | + | + | + | + | +++ | +++ | +++ | ++ |
Iloperidone | ++ | ++ | + | + | + | + | + | ++ | ++ | + | +++ | + |
Lumateperone¶ | + | + | + | + | + | + | + | + | + | + | + | * |
Lurasidone | + | ++ | ++ | ++ | ++ | ++ | ++ | + | ++ | + | + | * |
Olanzapine | +++ | +++ | +++ | ++ | ++ | + | + | ++ | +++ | ++ | ++ | ++ |
Paliperidone | ++ | + | ++ | ++ | ++ | ++ | ++ | +++ | + | + | ++ | + |
Pimavanserin | – | + | + | + | + | + | + | + | + | + | ++ | + |
Quetiapine | ++ | ++ | +++ | + | + | + | + | + | +++ | ++ | ++ | ++ |
Risperidone | ++ | ++ | + | ++ | ++ | ++ | ++ | +++ | ++ | + | ++ | ++ |
Ziprasidone | + | + | + | ++ | + | + | + | ++ | ++ | + | ++ | +++ |
First-generation agents | ||||||||||||
Chlorpromazine | ++ | ++ | + | ++ | ++ | ++ | +++ | + | +++ | +++ | +++ | +++ |
Fluphenazine | ++ | + | + | +++ | +++ | +++ | +++ | +++ | + | + | + | + |
Haloperidol | ++ | + | + | +++ | +++ | +++ | +++ | +++ | + | + | + | Oral: ++ IV: +++ |
Loxapine | + | + | + | ++ | ++ | ++ | ++ | ++ | ++ | ++ | ++ | * |
Molindone | + | + | + | ++ | ++ | ++ | ++ | ++ | ++ | + | + | * |
Perphenazine | ++ | + | + | ++ | ++ | ++ | ++ | ++ | ++ | ++ | ++ | * |
Pimozide | + | + | + | +++ | +++ | ++ | +++ | +++ | + | + | + | ++◊ |
Thioridazine§ | ++ | + | + | + | + | + | + | ++ | +++ | +++ | +++ | ++ |
Thiothixene | + | + | + | +++ | +++ | +++ | +++ | +++ | + | + | + | * |
Trifluoperazine | ++ | + | + | ++ | ++ | ++ | ++ | ++ | + | ++ | + | * |
IV: intravenous.
* Clinically significant QTc prolongation was not detected in preliminary studies or reported in the manufacturer's labeling.
¶ Based upon limited experience.
Δ Clozapine also causes granulocytopenia or agranulocytosis in approximately 1% of patients requiring regular blood cell count monitoring. Clozapine has been associated with excess risk of myocarditis and venous thromboembolic events including fatal pulmonary embolism. These issues are addressed in the UpToDate topic review of guidelines for prescribing clozapine section on adverse effects.
◊ Although the available evidence concerning the average QTc prolonging effect of pimozide is consistent with a classification of moderate significance (ie, ++), label warnings have characterized the QTc effect and cardiovascular risks as severe and sudden deaths in patients on pimozide have been reported.
§ Thioridazine is also associated with dose-dependent retinitis pigmentosa. Refer to UpToDate text.Do you want to add Medilib to your home screen?