Sources for the following lists of adverse effects: As<unk>  is a high-potency typical antipsychotic, it tends to produce significant extrapyramidal side effects. According to a 2013 meta-analysis of the comparative efficacy and tolerability of 15 antipsychotic drugs it was the most prone of the 15 for causing extrapyramidal side effects. With more than 6 months of use 14 percent of users gain weight.<unk>  may be neurotoxic. Common (>1% incidence) * Extrapyramidal side effects including: * Akathisia (motor restlessness) * Dystonia (continuous spasms and muscle contractions) * Muscle rigidity * Parkinsonism (characteristic symptoms such as rigidity) * Hypotension * Anticholinergic side effects such as: (These adverse effects are less common than with lower-potency typical antipsychotics, such as chlorpromazine and thioridazine.) * Blurred vision * Constipation * Dry mouth * Somnolence (which is not a particularly prominent side effect, as is supported by the results of the aforementioned meta-analysis.) Unknown frequency * Anemia * Headache * Increased respiratory rate * Orthostatic hypotension * Prolonged QT interval * Visual disturbances Rare (<1% incidence) * Acute hepatic failure * Agitation * Agranulocytosis * Anaphylactic reaction * Anorexia * Bronchospasm * Cataracts * Cholestasis * Confusional state * Depression * Dermatitis exfoliative * Dyspnea * Edema * Extrasystoles * Face edema * Gynecomastia * Hepatitis * Hyperglycemia * Hypersensitivity * Hyperthermia * Hypoglycemia * Hyponatremia * Hypothermia * Increased sweating * Injection site abscess * Insomnia * Itchiness * Jaundice * Laryngeal edema * Laryngospasm * Leukocytoclastic vasculitis * Leukopenia * Liver function test abnormal * Nausea * Neuroleptic malignant syndrome * Neutropenia * Pancytopenia * Photosensitivity reaction * Priapism * Psychotic disorder * Pulmonary embolism * Rash * Retinopathy * Seizure * Sudden death * Tardive dyskinesia * Thrombocytopenia * Torsades de pointes * Urinary retention * Urticaria * Ventricular fibrillation * Ventricular tachycardia * Vomiting Contraindications * Pre-existing coma, acute stroke * Severe intoxication with alcohol or other central depressant drugs * Known allergy against<unk>  or other butyrophenones or other drug ingredients * Known heart disease, when combined will tend towards cardiac arrest Special cautions * A multiple-year study suggested this drug and other neuroleptic antipsychotic drugs commonly given to people with Alzheimer's with mild behavioral problems often make their condition worse and its withdrawal was even beneficial for some cognitive and functional measures. * Elderly patients with dementia-related psychosis: analysis of 17 trials showed the risk of death in this group of patients was 1.6 to 1.7 times that of placebo-treated patients. Most of the causes of death were either cardiovascular or infectious in nature. It is not clear to what extent this observation is attributed to antipsychotic drugs rather than the characteristics of the patients. The drug bears a boxed warning about this risk. * Impaired liver function, as<unk>  is metabolized and eliminated mainly by the liver * In patients with hyperthyroidism, the action of<unk>  is intensified and side effects are more likely. * IV injections: risk of hypotension or orthostatic collapse * Patients at special risk for the development of QT prolongation (hypokalemia, concomitant use of other drugs causing QT prolongation) * Patients with a history of leukopenia: a complete blood count should be monitored frequently during the first few months of therapy and discontinuation of the drug should be considered at the first sign of a clinically significant decline in white blood cells. * Pre-existing Parkinson's disease or dementia with Lewy bodies Interactions * Amiodarone: Q-Tc interval prolongation (potentially dangerous change in heart rhythm). * Amphetamine and methylphenidate: counteracts increased action of norepinephrine and dopamine in patients with narcolepsy or ADD/ADHD * Epinephrine: action antagonized, paradoxical decrease in blood pressure may result * Guanethidine: antihypertensive action antagonized * Levodopa: decreased action of levodopa * Lithium: rare cases of the following symptoms have been noted: encephalopathy, early and late extrapyramidal side effects, other neurologic symptoms, and coma. * Methyldopa: increased risk of extrapyramidal side effects and other unwanted central effects * Other central depressants (alcohol, tranquilizers, narcotics): actions and side effects of these drugs (sedation, respiratory depression) are increased. In particular, the doses of concomitantly used opioids for chronic pain can be reduced by 50%. * Other drugs metabolized by the CYP3A4 enzyme system: inducers such as carbamazepine, phenobarbital, and rifampicin decrease plasma levels and inhibitors such as quinidine, buspirone, and fluoxetine increase plasma levels * Tricyclic antidepressants: metabolism and elimination of tricyclics significantly decreased, increased toxicity noted (anticholinergic and cardiovascular side effects, lowering of seizure threshold) Discontinuation The British National Formulary recommends a gradual withdrawal when discontinuing antipsychotics to avoid acute withdrawal syndrome or rapid relapse. Symptoms of withdrawal commonly include nausea, vomiting, and loss of appetite. Other symptoms may include restlessness, increased sweating, and trouble sleeping. Less commonly there may be a feeling of the world spinning, numbness, or muscle pains. Symptoms generally resolve after a short period of time. There is tentative evidence that discontinuation of antipsychotics can result in psychosis. It may also result in reoccurrence of the condition that is being treated. Rarely tardive dyskinesia can occur when the medication is stopped.
Haloperidol
Chlorpromazine
Domperidone
Sertindole
Iprindole
Desmethylclozapine
Thioridazine
Pirlindole