Management of medication-related adverse effects

Tolerability and safety considerations play a major role in selecting medications for patients with schizophrenia. With the exception of clozapine, recent data demonstrate that the efficacy of antipsychotics is similar across and within first and second generation agents. In contrast, there is great variation in the nature and severity of adverse effects among these agents which can markedly influence quality of life and adherence. Adverse effects over the short- and long term may produce permanent disability and at times can be life-threatening. Indeed, they contribute substantially to the diminished life expectancy of our patients. Hence, medication selection requires a thorough understanding of tolerability and safety considerations for each agent, as well as a careful assessment of the patient's risk factors and preferences.