Sideeffects of drugs

The older drugs cause extrapyramidal side-effects commonly, particularly increases in muscle tone (stiffness), and tremor; risperidone and the other atypi-cals can also cause these, though less frequently.

The main problem with the atypical medications has been weight gain, and olanzepine seems to be notable for this; it seems to have an appetite-stimulating effect, and cases of diabetes (Koro et al., 2002) have also been recorded. There is also a risk of stroke (Ballard et al., 2006) in elderly patients with Alzheimer's disease and behavioural problems, so that risperidone and olanzepine are now contraindicated in these patients. By extension, they would probably be best avoided in all elderly patients, and possibly also in all those with cerebral vascular risk factors of whatever age.

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