Anti-psychotic medications are very useful and have helped many people with schizophrenia to lead healthy and productive lives by taking care of some of the symptoms, including delusions, hallucinations, disorganized thinking, disorganized behavior, and negative symptoms, or lack of motivation that may come with schizophrenia. However, they don't come without side effects. I'm going to talk with you about four different categories of side effects that seem to be very common.
One is what we call extrapyramidal symptoms. Those are motor or movement side effects of these medications. The older anti-psychotics tend to have more of these side effects. They include feeling stiff in your muscles, having tremor in your hands or in your body, feeling restless and unable to sit still, or having what we call tardive dyskynesia. That occurs over time, where you might have movements of your mouth or of your limbs that are repetitive and that appear after a period of treatment. Those are the extrapyramidal symptoms, or EPS. They're more common with the older medications.
With the newer medications, the more common side effects tend to be what we call the metabolic side effects, or cardiometabolic side effects. Those include weight gain, an increased blood sugar or risk for diabetes, and an increased cholesterol. Initially, we were really excited about all of the new anti-psychotic medications.
Then, when we saw how people gained weight and got more heart disease, partly related to the medications, we started to see that there was a big risk there, because really, it's heart disease and diabetes that tend to be the things that lead to early mortality in people with schizophrenia. So, that's the second category of side effects.
There's also anticholinergic side effects. Those include dry mouth, feeling flushed or hot, having constipation. Those are things that tend to happen with the anticholinergic side effects. Different medications, both old and new, have more or less anticholinergic side effects.
One last category that I'll mention is prolactin. Prolactin is a body hormone that you have. For some of our anti-psychotic medications, in particular Risperidone, is probably the biggest culprit, increase prolactin production. What happens, then, is that women especially may not have their periods, they may have difficulty conceiving a child. And, for some people, there's breast enlargement and even lactation, both men and women. That can be a very disruptive side effect, obviously, and needs to be addressed.
If you have side effects with anti-psychotic medications, definitely, there's many choices of anti-psychotic medication, and so you should speak with your doctor or psychiatrist about it, because they can try different things to see what works best for you and causes the least burden of side effects to you. Many people have no side effects at all from anti-psychotic medications, thank goodness. If you have schizophrenia and you're thinking about medications, find a treatment provider you trust so you can work on finding the right medication for you.