Can antipsychotic medications, such as olanzapine (Olanzapine), risperidone (Risperidone), and quetiapine (Quetiapine), cause swollen hands due to fluid retention?

From the Guidelines

Antipsychotic medications like olanzapine, risperidone, and quetiapine can cause swollen hands due to fluid retention, a side effect known as peripheral edema. This side effect is relatively common with these medications, particularly with olanzapine and quetiapine, as they can interfere with the body's sodium balance and vascular permeability 1. The swelling typically affects the hands, feet, and ankles and results from the body retaining excess fluid in the tissues. Some key points to consider:

• If you notice swelling in your hands while taking these medications, you should not stop taking them abruptly but should contact your healthcare provider promptly.
• They may recommend monitoring the swelling, reducing your dosage, switching to a different antipsychotic with fewer edema-related side effects, or prescribing a diuretic to help reduce fluid retention 1.
• Elevating your hands when possible, reducing salt intake, and staying physically active may help manage mild swelling.
• The risk of edema varies between individuals and often depends on dosage, with higher doses typically increasing the likelihood of this side effect. It's essential to work closely with your healthcare provider to manage any side effects and find the best treatment approach for your specific needs.

From the Research

Antipsychotic Medications and Swollen Hands

• Antipsychotic medications, such as olanzapine, risperidone, and quetiapine, can cause various side effects, but the provided studies do not directly mention swollen hands as a common side effect 2, 3, 4.
• However, some antipsychotic medications can cause fluid retention, which may lead to swelling in different parts of the body, including the hands 5.
• A study on atypical antipsychotic drugs found that they can cause acute kidney injury, hypotension, and other adverse outcomes, which may be related to fluid retention 5.
• Another study compared the risk of cardiovascular events between olanzapine, quetiapine, and risperidone, but did not mention swollen hands as a side effect 6.
• It is essential to note that antipsychotic medications can have different side effect profiles, and some may be more likely to cause fluid retention than others 4.

Management of Side Effects

• If an antipsychotic medication is causing uncomfortable side effects, such as fluid retention, the first management choice is to lower the dose or adjust the dosing schedule 4.
• Changing the antipsychotic medication or adding concomitant medications may also be considered to manage side effects 4.
• It is crucial to weigh the benefits and risks of antipsychotic medications and to monitor patients closely for any adverse effects 4, 5.