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Life-Threatening Effects of Antipsychotic Drugs - 1st Edition - ISBN: 9780128033760, 9780128033906

Life-Threatening Effects of Antipsychotic Drugs

1st Edition

Editors: Peter Manu Robert Flanagan Kathlyn Ronaldson
Hardcover ISBN: 9780128033760
eBook ISBN: 9780128033906
Imprint: Academic Press
Published Date: 12th August 2016
Page Count: 394
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Life-Threatening Effects of Antipsychotic Drugs describes in detail more than 20 life-threatening effects associated with antipsychotics, presents the best available data on their incidence and case fatality, and gives comprehensive advice on diagnosis, management and preventive strategies. In addition, the book discusses the benefit of antipsychotic medication in a range of therapeutic indications, and demonstrates the gain in life-expectancy associated with clozapine use in severe mental illness despite its serious, potentially life-threatening adverse effects.

Key Features

  • Covers cardiovascular, neurological, muscular, hematological, gastrointestinal, autonomic and metabolic effects
  • Gives advice on risk factors, confounding diagnoses and measures to minimise seriousness
  • Discusses clozapine rechallenge after each of its serious adverse reactions
  • Makes suggestions for optimum management of somatic disease in those with severe mental illness, to improve life-expectancy
  • Includes data on post-mortem considerations


Psychiatrists, general and emergency physicians, pathologists, and mental health pharmacists

Table of Contents

  • List of Contributors
  • Foreword
    • The Art and Science of Balance: Managing the Efficacy and Safety of Antipsychotic Drugs
  • Preface
  • Acknowledgments
  • Symbols and Conventions
  • Part I: Cardiovascular Adverse Effects of Antipsychotic Drugs
    • Chapter 1. Sudden Cardiac Death and Ventricular Arrhythmias
      • Abstract
      • 1.1 Epidemiology
      • 1.2 Pathobiology
      • 1.3 Clinical and Laboratory Features
      • 1.4 Prevention and Management
      • References
    • Chapter 2. Myocarditis and Cardiomyopathy
      • Abstract
      • 2.1 Definitions
      • 2.2 Epidemiology
      • 2.3 Genetic Vulnerability
      • 2.4 Pathobiology
      • 2.5 Clinical and Laboratory Features
      • 2.6 Differential Diagnosis
      • 2.7 Complications and Significant Sequelae
      • 2.8 Risk Stratification for Death or Permanent Disability
      • 2.9 Management
      • 2.10 Prevention
      • Acknowledgment
      • References
    • Chapter 3. Pulmonary Embolism
      • Abstract
      • 3.1 Epidemiology
      • 3.2 Pathobiology
      • 3.3 Clinical and Laboratory Features
      • 3.4 Prevention and Management
      • References
    • Chapter 4. Orthostatic Hypotension
      • Abstract
      • 4.1 Epidemiology
      • 4.2 Pathobiology
      • 4.3 Clinical and Laboratory Features
      • 4.4 Prevention and Management
      • References
  • Part II: Hematological Complications of Treatment With Antipsychotic Drugs
    • Chapter 5. Severe Neutropenia and Agranulocytosis
      • Abstract
      • 5.1 Epidemiology
      • 5.2 Pathobiology
      • 5.3 Clinical and Laboratory Features
      • 5.4 Prevention and Management
      • References
  • Part III: Antipsychotic-Related Pathology of the Digestive System
    • Chapter 6. Gastrointestinal Hypomotility and Dysphagia
      • Abstract
      • 6.1 Gastrointestinal Hypomotility
      • 6.2 Dysphagia and Sialorrhea
      • Acknowledgment
      • References
    • Chapter 7. Liver Failure
      • Abstract
      • 7.1 Definition
      • 7.2 Search Strategy
      • 7.3 Epidemiology
      • 7.4 Pathobiology
      • 7.5 Clinical and Laboratory Features
      • 7.6 Management
      • 7.7 Prevention
      • 7.8 Conclusion
      • References
    • Chapter 8. Pancreatitis
      • Abstract
      • 8.1 Epidemiology
      • 8.2 Pathobiology
      • 8.3 Clinical and Laboratory Features
      • 8.4 Management
      • References
  • Part IV: Major Neurological and Neuromuscular Adverse Effects of Antipsychotic Drugs
    • Chapter 9. Seizures
      • Abstract
      • 9.1 Epidemiology
      • 9.2 Pathobiology
      • 9.3 Clinical and Laboratory Features
      • 9.4 Prevention and Management
      • Acknowledgment
      • References
    • Chapter 10. Neuroleptic Malignant Syndrome
      • Abstract
      • 10.1 Epidemiology
      • 10.2 Pathobiology
      • 10.3 Clinical and Laboratory Features
      • 10.4 Prevention and Management
      • References
    • Chapter 11. Heat Stroke and Rhabdomyolysis
      • Abstract
      • 11.1 Heat Stroke
      • 11.2 Rhabdomyolysis
      • References
  • Part V: Metabolic Complications of Antipsychotic Drug Treatment
    • Chapter 12. Type 2 Diabetes Mellitus
      • Abstract
      • 12.1 Epidemiology
      • 12.2 Pathobiology
      • 12.3 Clinical and Laboratory Features
      • 12.4 Prevention and Management
      • 12.5 Conclusion
      • References
  • Part VI: Other Life-Threatening Effects of Antipsychotic Drugs
    • Chapter 13. Interstitial Nephritis and Interstitial Lung Disease
      • Abstract
      • 13.1 Interstitial Nephritis
      • 13.2 Interstitial Lung Disease
      • References
  • Part VII: Clinical and Forensic Challenges in the Use of Antipsychotic Drugs
    • Chapter 14. The Benefits of Antipsychotic Drugs: Symptom Control and Improved Quality of Life
      • Abstract
      • 14.1 Therapeutic Objectives in Schizophrenia
      • 14.2 Pharmacology of Antipsychotic Drugs
      • 14.3 Symptom Reduction in Schizophrenia
      • 14.4 Relapse Prevention and Antipsychotic Maintenance Treatment
      • 14.5 Improving Quality of Life in Patients With Schizophrenia
      • 14.6 Antipsychotic Drugs in Treating Other Psychiatric Disorders
      • References
    • Chapter 15. Antipsychotic-Related Mortality: Risk and Strategy for Improved Clinical Management
      • Abstract
      • 15.1 Reduced Life-Expectancy with Severe Mental Illness (SMI)
      • 15.2 Suicide Reduced with Clozapine
      • 15.3 An Obstacle to Clozapine Prescribing: Agranulocytosis
      • 15.4 Diabetic Ketoacidosis: Poor Outcomes with Severe Mental Illness (SMI)
      • 15.5 Strategy for Improved Outcomes
      • References
      • Further Reading
    • Chapter 16. Forensic Investigation of Antipsychotic-Related Deaths
      • Abstract
      • 16.1 Introduction
      • 16.2 Clinical and Pathological Correlations
      • 16.3 Toxicological Assessments
      • 16.4 System-Specific Forensic Considerations
      • 16.5 Conclusions
      • References
  • Guide to the Interpretation of the Results of Some Chemical Pathology Tests
  • Index


No. of pages:
© Academic Press 2016
12th August 2016
Academic Press
Hardcover ISBN:
eBook ISBN:

About the Editors

Peter Manu

Peter Manu, MD is Professor of Medicine and Psychiatry at Hofstra University School of Medicine and Adjunct Professor of Clinical Medicine, Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York. He aditionally serves as Director of Medical Services, Hillside Hospital, Long Island Jewish Medical Center. Prior to this, he served as the Medical Director, Alcohol and Drug Abuse Treatment Center at the University of Connecticut Health Center. In 2012 he received the Fulbright Specialist in Public/Global Health award from the U.S. Department of State. He is the author of 5 books, 68 journal articles, and 30 book chapters in psychiatry. He serves as an ad hoc reviewer for 38 journals in the areas of psychology, psychiatry, medicine, and pharmacology.

Affiliations and Expertise

Hofstra Northwell School of Medicine and Albert Einstein College of Medicine, New York, NY, USA

Robert Flanagan

Professor Bob Flanagan is Consultant Clinical Scientist and Director, Toxicology Unit, King’s College Hospital NHS Foundation Trust and Clinical Lead for Toxicology, Sheffield Teaching Hospital NHS Foundation Trust. He has published over 200 scientific papers and four books. Particular interests have been treatment of mental illness especially as regards use of antipsychotics, notably clozapine, treatment of cancer, especially in respect of the use of tyrosine kinase inhibitors such as imatinib, and the diagnosis of substance abuse, especially misuse of volatiles such as butane. He led on toxicology training for the Association for Clinical Biochemistry for many years, and regularly advises medical professionals, police, coroners, and prosecution and defence lawyers on toxicological issues. He has also acted as a consultant to the United Nations Office for Drugs and Crime, most recently as regards advising on methodology for the detection of drug-facilitated crime, and to the World Health Organization, notably in Serbia/Kosovo in 2007, and also in the Middle East and in India. He is immediate past-President of the British Academy of Forensic Sciences.

Affiliations and Expertise

King's College Hospital, London, UK

Kathlyn Ronaldson

Affiliations and Expertise

Monash University, Melbourne, Australia


"… this book …presents important evidence-based information on side effects of antipsychotic drugs and how to prevent and counteract these. The book is organized in seven parts, all of them dealing with adverse effects of antipsychotic drugs in different organ systems: cardiovascular adverse effects, haematological complications, the digestive system, neurological and neuromuscular, metabolic complications, other life-threatening effects such as interstitial diseases in kidney and lung and, finally, a chapter dealing with clinical and forensic challenges in the use of antipsychotic drugs.

All subjects are treated in a consistent manner, starting with an epidemiological overview, followed by some background regarding pathobiology, continuing over clinical signs to management, ending up with suggestions for prevention of the conditions. The book has a richness of tables and figures facilitating the reading and understanding of the book’s important information and many messages of, e.g. Hazard ratios, odds ratios, clinical algorithms, all making it easily accessible.

… The book is highly relevant to the clinically working psychiatrist, his/her assistants, medical students and other with interest in the interphase between psychiatric illnesses, somatic diseases, their treatment and the always present balance between effect and side effects of treatments." --Mikkel Hojlund, Povl Munk-Jørgensen, Nordic Journal of Psychiatry

Ratings and Reviews