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©2013 UpToDate ® Print Email Selected adverse effects of antipsychotic medications for schizophrenia Weight gain/diabetes mellitus Hyper-cholesterolemia EPS/TD Prolactin elevation Sedation Anti-cholinergic side effects Orthostatic hypotension QTc prolongation First generation agents Chlorpromazine +++ +++ + ++ +++ +++ +++ + Fluphenazine + + +++ +++ + − − ND Haloperidol + + +++ +++ ++ − − + Loxapine ++ ND ++ ++ ++ + + + Perphenazine ++ ND ++ ++ ++ − − ND Pimozide + ND +++ ++ + + + ++ Thioridazine* ++ ND + +++ +++ ++++ ++++ +++ Thiothixene ++ ND +++ ++ + − + + Trifluoperazine ++ ND +++ ++ + − + ND Second generation agents [1] Aripiprazole − − + − + − − − Asenapine + − + ++ ++ − + + Clozapine • +++ +++ − − +++ +++ +++ + Iloperidone ++ ++ + − + + +++ ++ Lurasidone − − + + ++ − + − Olanzapine +++ +++ + − ++ ++ + + Paliperidone ++ + ++ +++ + − ++ + Quetiapine ++ +++ − − ++ + ++ ++ Risperidone ++ + ++ +++ + − ++ + Ziprasidone − − + + + − + ++ Adverse effects may be dose dependent. EPS: extrapyramidal symptoms; TD: tardive dyskinesia; ND: no data. * Thioridazine is also associated with dose-dependent retinitis pigmentosa. Refer to text. • Clozapine also causes granulocytopenia or agranulocytosis in approximately 1 percent of patients requiring regular blood cell count monitoring. Adapted from: Treatment Guidelines from The Medical Letter, August 2010; Vol. 8 (96):61. www.medicalletter.org .