18
Treatment
Antipsychotic medications: relative side effects of
oral formulations
Generic name Seizures Orthostasis QT prolongation
First-generation antipsychotics
Chlorpromazine ++ +++ +++
Fluphenazine + + ++
Haloperidol + + ++
Loxapine + ++ ++
Molindone + + ++
Perphenazine + ++ ++
Pimozide +++ + +++
Thioridazine ++ +++ +++
Thiothixene +++ + ++
Trifluoperazine + + ++
Second-generation antipsychotics
Aripiprazole + + +
Asenapine + ++ ++
Brexpiprazole + + ++
Cariprazine + + ++
Clozapine +++ +++ ++
Iloperidone + +++ +++
Lurasidone + + +
Olanzapine ++ ++ ++
Paliperidone + ++ ++
Quetiapine ++ ++ ++
Risperidone + ++ ++
Ziprasidone + ++ +++
+=seldom; ++=sometimes; +++=often
a
In general, rates of sexual dysfunction parallel rates of hyperprolactinemia except where
noted in comments.
b
Pigmentary retinopathy; high rates of sexual dysfunction; avoid use if QTc interval is >450
msec or with concomitant use of drugs that prolong the QTc interval or inhibit CYP2D6
c
FDA safety alert for impulse control disorders (e.g., gambling, binge eating); may reduce
hyperprolactinemia with other antipsychotics
