Evidence map›Paper›PMID 30192094›Full record

ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2018

Management of common adverse effects of antipsychotic medications.

T Scott Stroup, Neil Gray

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 248 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
248citing papers in PubMed, 9 pooled it
25.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

248 citing papers in PubMed, 9 syntheses or guidelines pooled it, 539 citations in OpenAlex.

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  6. Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2023
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  11. Improvements in health-related quality of life with esketamine nasal spray versus quetiapine extended release.European psychiatry : the journal of the Association of European Psychiatrists · 2025
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  17. Early Corrected QT Interval Changes Following First-dose Long-acting Injectable Antipsychotics: A Retrospective Inpatient Study.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026
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188 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

T Scott StroupNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Neil GrayDepartment of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Columbia University · USUniversity of Hawaiʻi at Mānoa · US

Funding

Columbia University
6 · The paper itself

Abstract

The benefits of antipsychotic medications are sometimes obscured by their adverse effects. These effects range from relatively minor tolerability issues (e.g., mild sedation or dry mouth) to very unpleasant (e.g., constipation, akathisia, sexual dysfunction) to painful (e.g., acute dystonias) to disfiguring (e.g., weight gain, tardive dyskinesia) to life-threatening (e.g., myocarditis, agranulocytosis). Importantly, adverse effect profiles are specific to each antipsychotic medication and do not neatly fit into first- and second-generation classifications. This paper reviews management strategies for the most frequent side effects and identifies common principles intended to optimize net antipsychotic benefits. Only use antipsychotics if the indication is clear; only continue antipsychotics if a benefit is discernible. If an antipsychotic is providing substantial benefit, and the adverse effect is not life-threatening, then the first management choice is to lower the dose or adjust the dosing schedule. The next option is to change the antipsychotic; this is often reasonable unless the risk of relapse is high. In some instances, behavioral interventions can be tried. Finally, concomitant medications, though generally not desirable, are necessary in many instances and can provide considerable relief. Among concomitant medication strategies, anticholinergic medications for dystonias and parkinsonism are often effective; beta-blockers and anticholinergic medications are useful for akathisia; and metformin may lead to slight to moderate weight loss. Anticholinergic drops applied sublingually reduce sialorrhea. Usual medications are effective for constipation or dyslipidemias. The clinical utility of recently approved treatments for tardive dyskinesia, valbenazine and deutetrabenazine, is unclear.

Indexed as

adverse effectsagranulocytosisakathisiaAntipsychoticsdystoniasimpulse control disordersmetabolic effectsneuroleptic malignant syndromeorthostatic hypotensionparkinsonismschizophreniasedationsexual functionsialorrheatardive dyskinesia

Identifiers

PMID30192094
PMCPMC6127750
OpenAlexW2892142575

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.