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Typical antipsychotics, also known as first-generation antipsychotics, are medications primarily used in the treatment of schizophrenia and other psychotic disorders. These drugs work by blocking dopamine receptors in the brain, which helps reduce symptoms such as hallucinations, delusions, and agitation (McCuistion et al., 2021). However, due to their mechanism of action, they can also produce a variety of adverse effects, some of which can be serious. Among the most common side effects are extrapyramidal symptoms, which include muscle rigidity, tremors, akathisia, and dystonias. These symptoms can appear shortly after starting treatment and are often a leading cause of treatment noncompliance.
Another important adverse effect is tardive dyskinesia, a neurological disorder characterized by repetitive involuntary movements, especially of the face, tongue, and extremities (Navarro et al., 2024). This effect can appear after prolonged use of typical antipsychotics and, in many cases, is irreversible, making it a particularly worrisome complication. Therefore, periodic monitoring using tools such as the Abnormal Involuntary Movement Scale (AIMS) is essential. Early detection of these symptoms allows for treatment adjustments or consideration of switching to an atypical antipsychotic, which tends to have a lower incidence of these types of effects. Constant clinical monitoring is key to preventing long-term complications.
In addition to motor effects, typical antipsychotics can cause side effects such as sedation, orthostatic hypotension, weight gain, dry mouth, and blurred vision. They can also alter cardiovascular parameters, such as the QT interval on the electrocardiogram, increasing the risk of life-threatening arrhythmias (Rosenthal & Burchum, 2021). In patients with a history of heart disease, these effects can pose a significant risk, so medical evaluations before and during treatment are recommended. It is important for nurses to be trained to identify warning signs and report any clinical changes in the patient. Effective communication among the healthcare team is essential to ensure safe care.
Patient education also plays a fundamental role in managing the adverse effects of antipsychotics. Nursing professionals should inform patients and their families about potential side effects and how to recognize them, as well as the importance of not discontinuing treatment without consulting a physician (Navarro et al., 2024). Furthermore, they should promote strategies to minimize risks, such as maintaining good hydration, avoiding alcohol consumption, and complying with clinical follow-ups. Patient empowerment through education improves therapeutic adherence and reduces the likelihood of complications. An informed patient is better able to make informed decisions about their health.
Finally, it is essential to adopt an individualized therapeutic approach, considering the patient’s medical history, comorbid conditions, and tolerance to the medication. Not all patients respond equally to the same drugs, so adjusting the dose or changing medications may be necessary. Nursing professionals should work with the medical team to design patient-centered care plans that balance the benefits of treatment with minimizing its adverse effects. This comprehensive approach allows for safer, more humane, and more effective care. In short, a thorough understanding of the adverse effects of typical antipsychotics is essential to optimizing treatment and ensuring the well-being of psychiatric patients.
References:
McCuistion, L. E., Vuljoin-DiMaggio, K., Winton, M. B., & Yeager, J. J. (2021). Pharmacology. A Patient-Centered Nursing Process Approach (11th Ed.). Elsevier.
Navarro, V. D., Navarro, M. T., Negre, E., Negre, C., Navarro, A. B., & Dalda, J. Á. (2024). Detection of sexual dysfunctions associated with the use of antipsychotics and antidepressants. Health Research Journal, 5(2), 2660-7085. https://dialnet.unirioja.es/servlet/articulo?codigo=9335621
Rosenthal, L. D., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd Ed.). Elsevier.
