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3.2 Central nervous system adverse effects

Antipsychotics can produce the following adverse effects on the central nervous system (CNS), but individual drugs vary considerably in their potential for the various neurological effects:

  • Sedation and sleep disturbances
  • Extrapyramidal effects1
  • Neuroleptic malignant syndrome
  • Convulsions Dizziness occurs with a number of antipsychotics, often as a result of postural hypotension — this is discussed further under cardiovascular adverse effects. Headache is reported frequently with some antipsychotics, especially on initiating treatment, but generally resolves spontaneously within a short period. Persistent headache calls for medication review.

  1. Extrapyramidal symptoms or side effects describe movement disorders such as acute dystonia, parkinsonian effects, akathisia and tardive dyskinesia; these effects result from disturbance—by dopamine antagonists—of the extrapyramidal system, which is responsible for involuntary reflexes and coordination of movement. (The voluntary movement system runs through the ‘pyramidal pathways’ of the medulla of the brain)