Sedation/Somnolence | Liver Enzyme Abnormality/Toxicity | Neutropenia and Agranulocytosis
Sedation is a frequent and often impairing antipsychotic side
effect that usually is dose dependent, although tolerance may develop.
An exception to the dose-dependent nature of sedation may be quetiapine, which
seems to be less sedating at dosages above 200–300 mg/day
where alpha-2 blockade sets in, increasing noradrenergic tone. Although
limited by different methodologies, a comparison of adult FDA labeling trials
with pediatric data suggested a similar rank order of sedation but
increased rates in youth (Correll et al. 2006). Sedation
rates were 0%–33% for aripiprazole, 42%–69% for
ziprasidone, 25%–80% for quetiapine, 29%–89% for
risperidone, 44%–94% for olanzapine, and
46%–90% with clozapine. These rates are
of particular concern in youth due to the potential interference with
learning and school performance.