204 - Switching antipsychotics

Switching antipsychotics

Schizophrenia and related psychoses CHAPTER 1 Switching antipsychotics Table 1.48 gives a summary of recommendations for switching antipsychotic medications because of poor tolerability. Table 1.48  Switching antipsychotic medications because of poor tolerability – a summary of recommendations. Adverse effect Suggested medications Alternative medications Acute EPS1–8 (dystonia, parkinsonism, bradykinesia) Aripiprazole Clozapine Brexpiprazole Lurasidone Cariprazine Ziprasidone Olanzapine Quetiapine Akathisia2,9,10 Olanzapine Clozapine Quetiapine Brexpiprazole Dyslipidaemia7,8,11–16 Amisulpride Asenapine Aripiprazole* Brexpiprazole Lurasidone Cariprazine Ziprasidone Impaired glucose tolerance7,8,15,17–21 Amisulpride Brexpiprazole Aripiprazole* Cariprazine Lurasidone Haloperidol Ziprasidone Hyperprolactinaemia7,8,15,22–29 Aripiprazole* Clozapine Brexpiprazole Olanzapine Cariprazine Ziprasidone Lurasidone Quetiapine Postural hypotension8,15,30 Amisulpride Haloperidol Aripiprazole Sulpiride Brexpiprazole Trifluoperazine Cariprazine Lurasidone QT prolongation27,31–38 Brexpiprazole Low-dose monotherapy of any drug not formally contraindicated in QT prolongation (with ECG monitoring) Cariprazine Lurasidone Paliperidone Sedation7,8,27 Amisulpride Haloperidol Aripiprazole Trifuoperazine Brexpiprazole Ziprasidone Cariprazine Risperidone Sulpiride Sexual dysfunction8,29,39–46 Aripiprazole Clozapine Brexpiprazole Cariprazine Lurasidone Quetiapine (Continued)