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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.

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