Side Effects of Antipsychotics in Chronological Order

Which of these side effects of antipsychotics occur earlier than the others?
A. Tardive dyskinesia
B. Akathisia
C. Parkinsonism
D. Hypothyroidism
E. Weight gain

Answer: Acute dystonia can occur within hours of starting antipsychotics (minutes if the IM or IV route is used) Tardive dystonia occurs after months to years of antipsychotic treatment. Acute akathisia occurs within hours to weeks of starting antipsychotics or increasing the dose. Tardive akathisia takes longer to develop and can persist after antipsychotics have been withdrawn. Tardive dyskinesia occurs in months to years. Weight gain may start early but it may not be evident for few weeks. Parkinsonism may take days to weeks after antipsychotic drugs are started or the dose is increased. Reference: The Maudsley Prescribing Guidelines in Psychiatry 12th Edition.

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