Antipsychotic and Neuroleptic Side Effects: Scoping Review with ☸️SAIMSARA.

Name: SAIMSARA Evidence Object mental::NEUROLEPTIC_SIDE_EFFECTS_PM
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsara690dd0a7

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Antipsychotic and Neuroleptic Side Effects: Scoping Review with ☸️SAIMSARA.

Mental & Neurological Health

Issue 4, Volume 1, 2026

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DOI: 10.62487/saimsara690dd0a7

Editorial note

• Last update: 2026-05-22 06:34:50

What is this paper about

Neuroleptic side effects are not only an EPS problem: the evidence map shows how motor toxicity, metabolic burden, endocrine disruption, sedation, autonomic effects, and patient-reported distress shift across drug classes and vulnerable populations. The full evidence map helps clinicians and researchers see where antipsychotics reduce risk, where they simply move toxicity into another domain, and why structured side-effect monitoring is essential in real-world care.

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Video summary generated from this ☸️SAIMSARA evidence map. Full reference-linked paper and evidence JSON are available after purchase.

Abstract: To map and synthesize original evidence on the side effects of neuroleptics, emphasizing recurrent adverse-effect patterns, vulnerable populations, mechanistic signals, treatment comparisons, monitoring implications, and research priorities. The review uses 140 references and builds its evidence map from 514 original studies with 419769 total participants/sample observations (topic-deduplicated ΣN). This scoping review indicates that the dominant signal across neuroleptic side-effect research remains extrapyramidal toxicity, with representative reports of dyskinesia in 44% of elderly treated patients, acute akathisia in 62% of inpatients within two weeks, and drug-induced parkinsonism in 32% of older patients on low-dose typical agents. Atypical agents and clozapine appear to attenuate but not eliminate motor burden, instead shifting toxicity toward metabolic, endocrine, autonomic, and sedative domains, while vulnerable groups—older adults, Lewy body and frontotemporal disorders, children, and specific pharmacogenetic subgroups—show heightened sensitivity. The evidence also highlights persistent discordance between clinician-rated and patient-reported burden, supporting structured side-effect elicitation in routine care. Given heterogeneous measurement and predominantly small studies, future work should prioritize harmonized adverse-effect endpoints and prospective vulnerability cohorts to clarify long-term, multidomain tolerability across contemporary neuroleptic regimens.

Keywords: Neuroleptic adverse effects; Extrapyramidal symptoms; Tardive dyskinesia; Drug-induced parkinsonism; Akathisia; Hyperprolactinemia; Antipsychotic polypharmacy; Weight gain; Clozapine tolerability; Dopamine D2 receptors

Review Stats

Final search date and database lock: 2026-05-17 01:56:01 CEST
Plan: Pro (expanded craft tokens; source: PubMed)
Source: PubMed
Total Abstracts/Papers: 1413
Downloaded Abstracts/Papers: 1413
Included original and non-original Abstracts/Papers (all): 699
Included original Abstracts/Papers (Vote counting by direction of effect): 514
Reference Index (links used in paper): 140
Total participants/sample observations (topic deduplicated ΣN): 419769

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Reference Index (140)

[1] Usage and Side Effects of Neuroleptics in Elderly Japanese Patients. — https://doi.org/10.1097/00019442-199503040-00005
[2] Acute extrapyramidal side effects: serum levels of neuroleptics and anticholinergics. — https://doi.org/10.1007/bf00433493
[3] The lithium ratio and the incidence of side effects. — https://doi.org/10.1016/s0278-5846(98)00058-x
[4] Clinical drug monitoring in child and adolescent psychiatry: side effects of atypical neuroleptics. — https://doi.org/10.1089/cap.2006.16.308
[5] Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics. — https://doi.org/10.1111/j.1600-0447.1996.tb10664.x
[6] Typical and atypical neuroleptics: differential effects of chronic administration on the activity of A9 and A10 midbrain dopaminergic neurons. — https://doi.org/10.1523/jneurosci.03-08-01607.1983
[7] Management of the violent patient. — https://doi.org/10.1080/10903120390937085
[8] [Influence of drugs on urological diseases]. — https://doi.org/10.1007/s00120-016-0040-6

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