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Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review

Overview of attention for article published in Therapeutics and Clinical Risk Management, June 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (79th percentile)
  • High Attention Score compared to outputs of the same age and source (93rd percentile)

Mentioned by

twitter
13 tweeters
facebook
2 Facebook pages

Citations

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146 Dimensions

Readers on

mendeley
333 Mendeley
Title
Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review
Published in
Therapeutics and Clinical Risk Management, June 2017
DOI 10.2147/tcrm.s117321
Pubmed ID
Authors

Marco Solmi, Andrea Murru, Isabella Pacchiarotti, Juan Undurraga, Nicola Veronese, Michele Fornaro, Brendon Stubbs, Francesco Monaco, Eduard Vieta, Mary Seeman, Christoph Correll, André Carvalho

Abstract

Since the discovery of chlorpromazine (CPZ) in 1952, first-generation antipsychotics (FGAs) have revolutionized psychiatric care in terms of facilitating discharge from hospital and enabling large numbers of patients with severe mental illness (SMI) to be treated in the community. Second-generation antipsychotics (SGAs) ushered in a progressive shift from the paternalistic management of SMI symptoms to a patient-centered approach, which emphasized targets important to patients - psychosocial functioning, quality of life, and recovery. These drugs are no longer limited to specific Diagnostic and Statistical Manual of Mental Disorders (DSM) categories. Evidence indicates that SGAs show an improved safety and tolerability profile compared with FGAs. The incidence of treatment-emergent extrapyramidal side effects is lower, and there is less impairment of cognitive function and treatment-related negative symptoms. However, treatment with SGAs has been associated with a wide range of untoward effects, among which treatment-emergent weight gain and metabolic abnormalities are of notable concern. The present clinical review aims to summarize the safety and tolerability profile of selected FGAs and SGAs and to link treatment-related adverse effects to the pharmacodynamic profile of each drug. Evidence, predominantly derived from systematic reviews, meta-analyses, and clinical trials of the drugs amisulpride, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, sertindole, ziprasidone, CPZ, haloperidol, loxapine, and perphenazine, is summarized. In addition, the safety and tolerability profiles of antipsychotics are discussed in the context of the "behavioral toxicity" conceptual framework, which considers the longitudinal course and the clinical and therapeutic consequences of treatment-emergent side effects. In SMI, SGAs with safer metabolic profiles should ideally be prescribed first. However, alongside with safety, efficacy should also be considered on a patient-tailored basis.

Twitter Demographics

The data shown below were collected from the profiles of 13 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 333 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 333 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 54 16%
Student > Bachelor 38 11%
Researcher 36 11%
Other 36 11%
Student > Ph. D. Student 31 9%
Other 85 26%
Unknown 53 16%
Readers by discipline Count As %
Medicine and Dentistry 125 38%
Pharmacology, Toxicology and Pharmaceutical Science 29 9%
Neuroscience 22 7%
Psychology 21 6%
Nursing and Health Professions 19 6%
Other 43 13%
Unknown 74 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 November 2020.
All research outputs
#2,610,598
of 17,036,910 outputs
Outputs from Therapeutics and Clinical Risk Management
#114
of 1,092 outputs
Outputs of similar age
#55,084
of 273,093 outputs
Outputs of similar age from Therapeutics and Clinical Risk Management
#2
of 15 outputs
Altmetric has tracked 17,036,910 research outputs across all sources so far. Compared to these this one has done well and is in the 84th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,092 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.9. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,093 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 79% of its contemporaries.
We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.