Adverse effects by incidence: Note: Serious (that is, those that can either result in permanent injury or are irreversible or are potentially life-threatening) are written in bold text. Very common (>10% incidence) adverse effects include: • Constipation • Dry mouth • Sedation
Common (1–10% incidence) adverse effects include: • Anxiety •
Ataxia • Blurred vision • Confusion • Dizziness • Headache • Fatigue • Nausea • Nervousness/restlessness • Excessive appetite • Rash • Increased perspiration (sweating) • Tremor • Palpitations • Nightmares • Excitement • Weakness • ECG changes •
Oedema. An abnormal accumulation of fluids in the tissues of the body leading to swelling. •
Prolactin levels increased. Prolactin is a hormone that regulates the generation of breast milk. Prolactin elevation is not as significant as with risperidone or haloperidol.
Uncommon/Rare (<1% incidence) adverse effects include: • Diarrhoea • Flatulence •
Hypertension (high blood pressure) •
Hypotension (low blood pressure) •
Syncope (fainting) •
Tachycardia (high heart rate) • Menstrual irregularity • Disturbance of accommodation •
Mydriasis (pupil dilation) •
Orthostatic hypotension (a drop in blood pressure that occurs upon standing up) •
Seizure •
Urinary retention (being unable to pass urine) •
Urticaria (hives) • Vomiting • Nasal congestion • Photosensitization •
Hypomania (a dangerously elated/irritable mood) • Tingling •
Paresthesias of the extremities •
Tinnitus • Disorientation • Numbness • Incoordination • Disturbed concentration • Epigastric distress • Peculiar taste in the mouth • Increased or decreased libido •
Impotence (difficulty achieving an erection) • Painful ejaculation •
Lacrimation (crying without an emotional cause) • Weight gain • Altered liver function • Breast enlargement • Drug fever •
Pruritus (itchiness) •
Vasculitis a disorder where blood vessels are destroyed by inflammation. Can be life-threatening if it affects the right blood vessels. •
Galactorrhoea (lactation that is not associated with pregnancy or breast feeding) • Delayed micturition (that is, delays in urination from when a conscious effort to urinate is made) •
Hyperthermia (elevation of body temperature; its seriousness depends on the extent of the hyperthermia) •
Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) this is basically when the body's level of the hormone,
antidiuretic hormone, which regulates the conservation of water and the restriction of blood vessels, is elevated. This is potentially fatal as it can cause electrolyte abnormalities including
hyponatraemia (low blood sodium),
hypokalaemia (low blood potassium) and
hypocalcaemia (low blood calcium) which can be life-threatening. •
Agranulocytosis a drop in white blood cell counts. The white blood cells are the cells of the immune system that fight off foreign invaders. Hence agranulocytosis leaves an individual open to life-threatening infections. •
Leukopaenia the same as agranulocytosis but less severe. •
Neuroleptic malignant syndrome (a potentially fatal reaction to antidopaminergic agents, most often antipsychotics. It is characterised by hyperthermia, diarrhoea, tachycardia, mental status changes [e.g. confusion], rigidity, extrapyramidal side effects) •
Tardive dyskinesia a most often irreversible neurologic reaction to antidopaminergic treatment, characterised by involuntary movements of facial muscles, tongue, lips, and other muscles. It develops most often only after prolonged (months, years or even decades) exposure to antidopaminergics. •
Extrapyramidal side effects. Motor symptoms such as tremor,
parkinsonism, involuntary movements, reduced ability to move one's voluntary muscles, etc.
Unknown incidence or relationship to drug treatment adverse effects include: •
Paralytic ileus (paralysed bowel) •
Atrial arrhythmias including
atrial fibrillation •
Myocardial infarction (heart attack) •
Stroke •
Heart block •
Hallucinations •
Purpura •
Petechiae • Parotid swelling • Changes in blood glucose levels •
Pancreatitis swelling of the pancreas •
Hepatitis swelling of the liver • Urinary frequency • Testicular swelling •
Anorexia (weight loss) •
Alopecia (hair loss) •
Thrombocytopenia a significant drop in platelet count that leaves one open to life-threatening bleeds. •
Eosinophilia an elevated level of the eosinophils of the body. Eosinophils are the type of immune cell that's job is to fight off parasitic invaders. •
Jaundice yellowing of the skin, eyes and mucous membranes due to an impaired ability of the body to clear the by product of haem breakdown,
bilirubin, most often the result of liver damage as it is the liver's responsibility to clear bilirubin. It tends to produce less
anticholinergic effects, sedation and weight gain than some of the earlier TCAs (e.g.
amitriptyline,
clomipramine,
doxepin,
imipramine,
trimipramine). It may also be less cardiotoxic than its predecessors. ==Overdose==