Adverse Reactions

Antipsychotic drugs are used to manage acute and chronic psychoses. In addition to its antipsychotic properties, chlorpromazine (Thorazine) is used to treat uncontrollable hiccoughs. Clozapine (Clozaril) is used only in patients with schizophrenia that is unresponsive to other antipsychotic drugs. Lithium is effective in the management of bipolar (manic-depressive) illness. Some of these drugs, such as chlorpromazine (Thorazine) and prochlorperazine (Compazine), are used as antiemetics (see Chap. 34). When given in small doses, neuroleptics are effective in the control of acute agitation in the elderly. More specific uses of these drugs are given in the Summary Drug Table: Antipsychotic Drugs.

Administration of these drugs may result in a wide variety of adverse reactions. The adverse reactions seen with the use of some of these drugs may include sedation, hypotension, postural hypotension, dry mouth, nasal congestion, photophobia (an intolerance to light), urticaria, photosensitivity (abnormal response or sensitivity when exposed to light), behavioral changes, and headache. Photosensitivity can result in severe sunburn when patients taking antipsychotic drugs are exposed to the sun or ultraviolet light.

Behavioral changes may also occur with the use of the antipsychotic drugs. These changes include an increase in the intensity of the psychotic symptoms, lethargy, hyper-activity, paranoid reactions, agitation, and confusion. A

decrease in dosage may eliminate some of these symptoms, but it also may be necessary to try another drug.

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