EPS Profiles: The Atypical Antipsychotics: Are Not All the Same

  title={EPS Profiles: The Atypical Antipsychotics: Are Not All the Same},
  author={Peter J. Weiden},
  journal={Journal of Psychiatric Practice},
  • P. Weiden
  • Published 1 January 2007
  • Psychology, Medicine
  • Journal of Psychiatric Practice
Within the first few years after chlorpromazine began to be used to treat psychosis, it was observed that it could cause many kinds of neurologic reactions that resembled those seen in idiopathic Parkinson's disease. These reactions were termed "extrapyramidal side effects" (EPS) because of their resemblance to the signs of Parkinson's disease, which were associated with degeneration of the dopamine nerve tracks located in the extrapyramidal region of the central nervous system. Eventually this… 

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  • 2011
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  • 2008
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Are Atypical Antipsychotics the Least Detrimental Alternative?

  • Holly Breton
  • Psychology, Medicine
    McMaster University Medical Journal
  • 2019
The benefits of the atypical antipsychotics (reduced extrapyramidal symptoms) outweigh the potential risks for the majority of patients, and metabolic syndrome may be preventable in highly motivated and well-supported patients.


It was concluded that both classes of antipsychotic drugs lead to EPS, and a higher incidence of EPS was observed with those prescribed with Olanzapine and Risperidone in the present study.

Quetiapine XR – A New Retard Formulation in the Treatment of Schizophrenia

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  • 2009
Simpler dosing regimens and fewer side effects help to establish higher rates of drug adherence in schizophrenic patients, and these characteristics are supposed to account for the ‘atypical’ properties of second-generation antipsychotics.

The many faces of psychosis in the elderly

There is support for the use of antipsychotic drugs for all types of psychosis in the elderly and while the atypical antipsychotics have a ‘black box warning’ on risk of death in elderly patients with dementia, the typical antippsychotics carry an even higher risk ofdeath and adverse effects.



Atypical antipsychotics in the EPS-vulnerable patient

  • J. Friedman
  • Psychology, Medicine
  • 2003

New atypical antipsychotic medications.

Extrapyramidal Side Effects of Antipsychotic Treatment: Scope of Problem and Impact on Outcome

  • R. TandonM. Jibson
  • Psychology, Medicine
    Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists
  • 2002
The newer generation of “atypical” antipsychotic agents are significantly better than conventional agents with regard to EPS, and this EPS advantage of atypical antipsychotics translates into several important benefits, including better negative symptom efficacy, less dysphoria, less impaired cognition, a lower risk of TD, and better overall outcome.

Half a century of antipsychotics and still a central role for dopamine D2 receptors

  • S. KapurD. Mamo
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    Progress in Neuro-Psychopharmacology and Biological Psychiatry
  • 2003

Relationship between dopaminergic and serotonergic neuronal activity in the frontal cortex and the action of typical and atypical antipsychotic drugs

Evidence is reviewed here the evidence that some, or all, of these advantages of the new generation of antipsychotic drugs are related to their actions at serotonin and dopamine receptors.

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Assessment of immediate and later follow-up treatment of psychotic patients indicates that moderate doses are adequate for most patients, and moderate doses of neuroleptics appear, on average, to be about as effective as, and probably safer than, the larger doses that have been popular in the United States in recent years.

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  • H. Meltzer
  • Psychology, Biology
    Schizophrenia bulletin
  • 1991
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In this relatively brief study, the apparently increased comparative risk of agranulocytosis requires that the use of clozapine be limited to selected treatment-resistant patients.