Appropriateness

• Side effects


  • Clinicians have been found in breach of Human Rights Act for administering drugs with such severe extrapyramidal side effects
  • Parkinsonism - features of Parkinson's; tremors, 1-4 weeks
  • Akathesia - restlessness, desire to walk around, 5-60 days
  • Tardive dyskinesia - involuntary movements, months to years after
  • Clozapine - agranulocytosis; blood thickening
  • Metabolic effects - weight gain etc.
  • Neuroleptic Malignant Syndrome - death
• Cost


  • Atypical APs can cost up to 4 time as much as typical APs
  • Murray - "schizophrenia costs the NHS more than cancer"