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Hypertension Schizophrenia and related psychoses CHAPTER 1 Antipsychotics with a high affinity for postsynaptic α1-­adrenergic receptors are most frequently implicated in postural hypotension. Among the SGAs, the reported incidence is highest with clozapine (2...

References 184 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 dopamine receptor antagonism.9 All five dopamine receptor subtypes (D1–5) are known to be involved in renal sodium excretion and blood pressure regulation.9 Antipsychotics vary in thei...

Antipsychotic-associated hyponatraemia 186 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Antipsychotic-­associated hyponatraemia Hyponatraemia can occur in the context of: ■ ■Water intoxication, where water consumption exceeds the maximal renal ...

References 188 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 References de Leon J, et al. Polydipsia and water intoxication in psychiatric patients: a review of the epidemiological literature. Biol Psychiatry 1994; 35:408–419. Patel JK. Polydip...

Hyperprolactinaemia 190 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Hyperprolactinaemia is often superficially asymptomatic (that is, the patient does not spontaneously report problems) and there is some evidence that hyperprolactinaemia does ...

Contraindications

References 20 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 References Royal College of Psychiatrists. The Risks and Benefits of High-­Dose Antipsychotic Medication. College Report CR190. London: Royal College of Psychiatrists; 2014. Paton C, e...

Management

Summary of management Schizophrenia and related psychoses CHAPTER 1 Contraindications Prolactin-­elevating drugs with high risk should, if possible, be avoided in the following patient groups: ■ ■Patients under 25 years of age (i.e. before peak bone mass). ■ ■...

References Schizophrenia and related psychoses CHAPTER 1 References Suzuki Y, et al. Differences in plasma prolactin levels in patients with schizophrenia treated on monotherapy with five second-­generation antipsychotics. Schizophr Res 2013; 145:116–119. Tsu...

Sexual dysfunction and antipsychotics

The human sexual response

Effects of psychosis Schizophrenia and related psychoses CHAPTER 1 Sexual dysfunction and antipsychotics A 2023 meta-­analysis found the global prevalence of sexual dysfunction in people with schizophrenia to be 56% in men and 60% in women.1 Problems are not a...

Effects of antipsychotic drugs 196 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 People with psychosis are less able to develop good psychosexual relationships and, for some, treatment with an antipsychotic can improve sexual functioning via an ...

Treatment of sexual dysfunction 198 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 Treatment of sexual dysfunction Before attempting to treat sexual dysfunction, a thorough assessment is essential to determine the most likely cause. A large meta-...

References 200 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 The evidence base supporting the use of ‘antidotes’ is often poor and specific to particular drug-­induced problems.33,106 The generalisability of results from positive trials is limit...

Pneumonia

Combined antipsychotics (antipsychotic polypharmacy)