Table 16.17-4. Dosing and adverse effects of selected antipsychotics

Initial dose (mg/d)

Usual therapeutic dose range (mg/d)

Notable adverse effects

First-generation antipsychotics

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-generation antipsychotics

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

EPS, extrapyramidal symptom; IM, intramuscular; IV, intravenous; LAI, long-acting injectable; ODT, orally dissolving/disintegrating tablet; PO, oral.