The side-effects of weight gain and diabetes are covered elsewhere.  Traditional anti-psychotics cause more extrapyramidal, akathisia, akinesia, tardive dyskinesia, and neuroleptic malignant side-effects than the newer atypical anti-psychotics.  These are covered above.  Despite all of the promotion of the newer and much more expensive atypicals, their advantages are relatively minor.

More and more information on side-effects are finally coming out after these drugs have become some of the most profitable drugs in the world.  The profit margins are huge.  Risperdal, for instance, costs $300-$500 per month for the common dosage, but generic risperidone purchased from India costs only $6-$10 per month, i.e., just 2% of the price in the U.S.

The big concerns are weight gain, obesity, diabetes, and increased death rates in the elderly from these medications.  The worst offenders for weight gain and diabetes are Clozaril and Zyprexa, followed by Seroquel and Risperdal.  Fortunately, Geodon and Abilify mostly avoid those problems.

Polydipsia: Clonidine and Enalapril Both Helpful: In a 6-month DB PC crossover study of 14 chronically psychotic VA hospital patients with chronic water abuse, both clonidine and enalapril were successful at decreasing fluid consumption in 60% of patients. Benefits often took over 1 month to become apparent. Polydipsia in chronic psychiatric patients: therapeutic trials of clonidine and enalapril. Greendyke RM, Bernhardt AJ, et al. VA, Canadaigua, New York, Neuropsychopharmacology. 1998 Apr;18(4):272-81.

Thomas E. Radecki, M.D., J.D.

modern-psychiatry.com