From the Guidelines
Medications that can cause antipsychotic side effects, also known as extrapyramidal symptoms (EPS) or dystonic reactions, include typical antipsychotic agents such as haloperidol, fluphenazine, thiothixene, trifluoperazine, molindone, perphenazine, and loxapine, as well as some atypical antipsychotic agents like risperidone, which may cause EPS at higher doses 1. These side effects can occur due to the medications' effects on the dopaminergic system in the brain. Some key points to consider when prescribing these medications include:
- Starting with low doses and gradually increasing as needed and tolerated
- Monitoring for signs of EPS, such as tremors, rigidity, and bradykinesia
- Being aware of the potential for dystonic reactions, which can be severe and require immediate treatment
- Considering alternative medications or adjusting the dosage if EPS occur Other medications that can cause EPS or dystonic reactions include:
- Antiemetics like metoclopramide
- Antidepressants like selective serotonin reuptake inhibitors (SSRIs) in rare cases
- Some antibiotics, such as fluoroquinolones, and antihistamines, like diphenhydramine 1 It's essential to carefully evaluate the benefits and risks of these medications and to monitor patients closely for any signs of EPS or dystonic reactions. In general, atypical antipsychotics are preferred over typical antipsychotics due to their lower risk of EPS, but they can still cause these side effects, especially at higher doses 1. If you're experiencing unexpected medication effects, please consult your healthcare provider for proper evaluation.
From the Research
Medications Causing Antipsychotic Side Effects
The provided studies do not directly address the question of medications that can cause antipsychotic side effects, also known as extrapyramidal symptoms (EPS) or dystonic reactions. However, some studies mention medications that can cause serotonin syndrome, which may be related to antipsychotic side effects.
Medications Associated with Serotonin Syndrome
- Dextromethorphan: Supra-therapeutic doses of dextromethorphan can cause serotonin syndrome, especially when combined with selective serotonin reuptake inhibitors (SSRIs) 2.
- Buspirone: Buspirone can cause an adverse reaction when given with other serotonergic drugs, such as fluoxetine, which may lead to serotonin syndrome 3.
- Selective serotonin reuptake inhibitors (SSRIs): SSRIs, such as fluoxetine and sertraline, can contribute to serotonin syndrome when combined with other medications or substances 3, 2.
Other Medications with Potential Adverse Effects
- Antidepressants: Newer antidepressants, such as duloxetine, mirtazapine, and trazodone, may interact with warfarin and increase the risk of bleeding events 4.
- Anorexigens: Agents affecting serotonin metabolism, such as anorexigens, have been linked to pulmonary arterial hypertension 5.
- Interferon and related medications: Interferon alfa and sofosbuvir have been associated with pulmonary arterial hypertension in patients with other risk factors 5.
Note that these studies do not provide direct evidence for medications causing antipsychotic side effects, but rather highlight potential adverse effects and interactions associated with certain medications.