SCHIZOPHRENIA Factsheet March 2019

What are antipsychotics? Antipsychotics are effective for the symptoms of schizophrenia. Positive symptoms include the experiences of perceptual abnormalities (hallucinations) and fixed, false, irrational beliefs (delusions). Negative symptoms include a lack of ordinary mental activities such as emotional expression, social engagement, and motivation. Antipsychotics can also cause side effects. These include extrapyramidal symptoms such NeuRA (Neuroscience Research Australia) as dyskinesias (repetitive, involuntary, and purposeless body or facial movements), Parkinsonism (cogwheel is one of the largest muscle rigidity, pill-rolling tremor and reduced or slowed movements), akathisia (motor restlessness, especially independent medical in the legs, and resembling agitation), and dystonias (muscle contractions causing unusual twisting of parts and clinical research of the body, most often in the neck). These effects are caused by the dopamine receptor antagonist action of institutes in Australia antipsychotics. Other side effects may include weight, hormonal and metabolic changes, increased sedation, and an international leader in neurological and ventricular anomalies (QTc prolongation). Randomised controlled trials compare antipsychotics with research. placebo to assess their individual effectiveness and side effects. Diseases of the brain What is the evidence for antipsychotic effectiveness and side effects? and nervous system High quality evidence shows a large effect of improved symptoms with clozapine compared to placebo. pose the greatest health, Amisulpride, risperidone, paliperidone, zotepine, haloperidol, quetiapine and aripiprazole all show medium- economic and social burden of any disease sized effects for improving symptoms, and sertindole, ziprasidone, chlorpromazine, asenapine, lurasidone, group because they are and iloperidone all show small to medium-sized effects. For side effects, high quality evidence shows small chronic, debilitating and effects of weight gain with aripiprazole, amisulpride, asenapine, and paliperidone; medium-sized effects with have no known cures. risperidone, quetiapine, sertindole, chlopromazine, iloperidone, clozapine, zotepine, and olanzapine; and no effect of weight gain with haloperidol, ziprasidone, or lurasidone compared to placebo. There are small effects Medical research is the cornerstone of efforts of increased prolactin concentrations with ziprasidone and lurasidone; medium-sized effects with sertindole to advance the health and haloperidol; and large effects with risperidone and paliperidone. No differences were found in prolactin and wellbeing of families concentrations between placebo and aripiprazole, quetiapine, asenapine, chlorpromazine, or iloperidone. High and the community. Our quality evidence shows small effects of increased QTc prolongation with haloperidol, quetiapine, olanzapine, dedicated scientists risperidone, and iloperidone; medium-sized effects with ziprasidone, amisulpride; and a large effect for are focussed on sertindole. No differences in QTc prolongation were reported between placebo and lurasidone, aripiprazole, transforming their research into significant paliperidone, or asenapine. Moderate quality evidence shows a small effect of less extrapyramidal side-effects and practical with clozapine compared to placebo. Small effects of increased extrapyramidal side-effects are found with benefits for all patients. ziprasidone, paliperidone, and risperidone; medium-sized effects with lurasidone, chlorpromazine, zotepine, and haloperidol; and no differences are found between placebo and sertindole, olanzapine, quetiapine, While we hope you find aripiprazole, iloperidone, amisulpride or asenapine. Moderate quality evidence shows medium to large effects this information useful, it is always important to of more sedation with aripiprazole, lurasidone, risperidone, haloperidol, asenapine, olanzapine, quetiapine, discuss any questions and ziprasidone than with placebo. Large effects of sedation are found with chlorpromazine, zotepine and about schizophrenia or clozapine. No effect of sedation is found between placebo and amisulpride, paliperidone, sertindole, and its treatment with your iloperidone. doctor or other health For more information see the technical table care provider.

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