Side Effects

Honest information about antipsychotic side effects — what's common, what's serious, and what to do.

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Stopping antipsychotics: discontinuation symptoms, supersensitivity, how to taper

Stopping antipsychotic medication is rarely simple. This guide covers discontinuation symptoms, supersensitivity, relapse risk, and how to taper safely with a clinician.

Nightmares on antipsychotics: causes and management

Some antipsychotics produce vivid dreams or nightmares — sometimes intense enough to disrupt sleep. Here is the mechanism and what helps.

QT prolongation and antipsychotics

Some antipsychotics lengthen the QT interval on ECG enough to raise the risk of dangerous arrhythmias. Here is which agents matter, and what monitoring looks like.

Swelling and edema from antipsychotics: what is going on

Peripheral edema — swelling of the lower legs and feet — is an uncommon but recognised antipsychotic side effect. Here is the differential and what to do about it.

Neuroleptic malignant syndrome (NMS): a medical emergency

Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal reaction to antipsychotic medication. Recognising the warning signs early can save a life.

Metabolic syndrome from antipsychotics

Metabolic syndrome is the cluster of risk factors — abdominal weight, glucose, lipids, blood pressure — that drives cardiovascular disease. Antipsychotics push every one of them in the wrong direction.

Nasal congestion from antipsychotics: an alpha-1 effect

Persistent stuffy nose on an antipsychotic is usually not allergy or infection — it is alpha-1 receptor blockade dilating nasal blood vessels. Here is the workup and treatment.

Antipsychotic-induced diabetes: a deeper look

Some antipsychotics raise diabetes risk even in patients who do not gain weight. Here is the mechanism, the monitoring, and the management.

QT prolongation and antipsychotics: which medications, what monitoring

QT prolongation is a heart-rhythm risk associated with some antipsychotics. Most cases are clinically silent, but the risk is real and worth understanding for monitoring decisions.

Heat intolerance and antipsychotics: heat-stroke risk

Antipsychotics impair sweating and the brain's temperature regulation, raising heat-stroke risk in hot weather. Here is the practical playbook for staying safe in summer.

Antipsychotic weight gain: causes and management

Antipsychotic weight gain is biological, predictable, and partly preventable. Here is what is happening at the receptor level and what actually works to limit it.

Orthostatic hypotension from antipsychotics: dizziness on standing

Lightheadedness or fainting on standing is a common — and underrecognised — side effect of several antipsychotics. The good news: it usually responds to simple measures.

Photosensitivity from antipsychotics: real sunburn risk

Some antipsychotics — especially the older phenothiazines — make your skin dramatically more sensitive to sunlight. Knowing this prevents painful sunburns and lasting skin damage.

Sexual side effects of antipsychotics: a deeper look

Sexual side effects are among the most common reasons people quietly stop their antipsychotic. They are also among the most treatable when named.

Constipation from antipsychotics — including the rare risk of clozapine ileus

Constipation from antipsychotics is more than an inconvenience — with clozapine in particular it can progress to ileus and bowel obstruction. Daily prevention is the key.

Tardive dyskinesia: what it is, who's at risk, and what to do about it

Tardive dyskinesia (TD) — involuntary movements caused by long-term antipsychotic use — is one of the most feared side effects of these medications. New treatments have changed the picture significantly.

Managing antipsychotic weight gain: an evidence-based guide

Weight gain is the most common reason people stop their antipsychotic — and one of the most preventable. Here's what actually works.

Orthostatic hypotension: feeling faint on antipsychotics

Orthostatic hypotension — a drop in blood pressure on standing — is common when starting many antipsychotics. Here is the mechanism, the risks, and a practical playbook.

Extrapyramidal symptoms (EPS): the movement side effects of antipsychotics

Movement side effects of antipsychotics — known as extrapyramidal symptoms or EPS — come in four main types. Each has its own warning signs and treatments.

Hyperprolactinemia from antipsychotics: a deep dive

Some antipsychotics raise prolactin levels enough to cause symptoms — from missed periods and breast tenderness to long-term bone loss. Here is what to monitor and what to do.

Dry mouth (xerostomia) from antipsychotics

Dry mouth from antipsychotics seems minor but can damage teeth, disrupt sleep, and worsen quality of life. Active management — and dental care — make a big difference.

Metabolic syndrome and antipsychotics: the silent risk

People with schizophrenia die 15–20 years earlier than average — mostly from heart disease. Antipsychotic-related metabolic effects are the biggest modifiable cause.

Severe constipation on antipsychotics: when to worry

Constipation is one of the most underestimated antipsychotic side effects. On clozapine in particular it can rarely become life-threatening. Here is what to do — and when to worry.

Clozapine and agranulocytosis: the REMS program explained

Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia — and the only one that requires blood monitoring for life. Here is what the REMS program is, and where it is heading.

Akathisia: the inner restlessness — recognising and treating it

Akathisia is a hard-to-describe inner restlessness — a need to move that is impossible to satisfy. Recognising it early matters; it is treatable and is linked to suicide risk if missed.

Urinary retention from antipsychotics: causes and care

Urinary hesitancy and incomplete emptying can be a quiet but important side effect of antipsychotics, especially those with anticholinergic activity. Here is what to know.

Sedation from antipsychotics: which ones, when it improves, what to do

Sedation is so common with antipsychotics that it is often confused with the illness itself. Knowing which drugs sedate most — and how to manage it — can transform daily life.

NMS (Neuroleptic Malignant Syndrome): a deep dive

NMS is rare — but when it happens, hours matter. The full clinical picture, the differential, and what re-introduction of antipsychotics looks like afterward.

Blurred vision from antipsychotics: what is going on

Blurred vision on antipsychotics is usually a temporary anticholinergic effect on the eye's focusing muscle — but a small number of vision changes need urgent evaluation.

Sexual side effects of antipsychotics: libido, arousal, ejaculation, what helps

Sexual side effects from antipsychotics are very common and very under-discussed. They are usually treatable — but only if patient and prescriber are willing to have the conversation.

Akathisia: causes, treatment, lived experience

Akathisia is one of the most distressing antipsychotic side effects — and one of the most under-recognised. Knowing what it feels like is the first step in getting it treated.

Dry mouth from antipsychotics: causes and what helps

Dry mouth from antipsychotics is annoying but also a real risk for tooth decay. Here is what causes it and a practical menu of things that help.

Hyperprolactinaemia from antipsychotics: galactorrhoea, periods, sexual effects

Several antipsychotics raise the hormone prolactin, which can disrupt periods, cause unwanted milk production, and affect sex drive. Most cases are manageable once recognised.

EPS (extrapyramidal symptoms): a deep dive

Extrapyramidal symptoms are the family of movement side effects produced by dopamine-blocking medications. Understanding the four sub-types — and how they overlap — changes how they get treated.