|
Initial dose (mg/d) |
Usual therapeutic dose range (mg/d) |
Notable adverse effects |
|
|
First-generation antipsychotics |
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|
Haloperidol (high potency) PO, IM, IV, LAI |
1-2 |
2-10 |
– EPSs – QTc prolongation – Hyperprolactinemia |
|
Perphenazine (mid potency) PO |
4-8 |
12-24 |
– EPS (less than haloperidol) – Sedation (less than CPZ) – Weight gain (less than CPZ) – Anticholinergic (less than CPZ) – Orthostatic hypotension (less than CPZ) |
|
Chlorpromazine (CPZ) (low potency) PO |
25-50 |
300-600 |
– Sedation – Weight gain – Anticholinergic – Orthostatic hypotension – QTc prolongation – Impaired glucose metabolism |
|
Second- and third-generation antipsychotics |
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|
Risperidone PO, ODT, LAI |
0.5-1 |
2-8 |
– EPSs – Hyperprolactinemia – Weight gain – Sedation – Impaired glucose metabolism |
|
Olanzapine PO, ODT, IM |
2.5-5 |
5-20 |
– Weight gain – Sedation – Dyslipidemia – Impaired glucose metabolism |
|
Quetiapine PO |
25-50 |
400-800 |
– Weight gain – Sedation – Dyslipidemia – Impaired glucose metabolism – Orthostatic hypotension |
|
Aripiprazole PO, LAI |
2-5 |
10-30 |
Akathisia |
|
Brexpiprazole PO |
0.5-1 |
2-4 |
– Akathisia, tremor – Somnolence – Weight gain |
|
Cariprazine PO |
1.5 |
1.5-6 |
– EPSs – Insomnia – Weight gain |
|
Lumateperone PO |
42 |
42 (dose titration not required) |
– EPSs – Sedation, somnolence – Weight gain |
|
Pimavanserin (indicated for Parkinson disease psychosis) PO |
34 (capsules) 10 (tablets) |
34 (capsules) 10 (tablets) (dose titration not required) |
– Nausea, constipation – Peripheral edema – Gait disturbances |
|
EPS, extrapyramidal symptom; IM, intramuscular; IV, intravenous; LAI, long-acting injectable; ODT, orally dissolving/disintegrating tablet; PO, oral. |
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