Second Generation Antipsychotic Medications: Benefits and Side Effects

This report discusses the benefits and side effects of second generation antipsychotic medications (SGAs). It covers the use of SGAs, pre-existing physical health status for people with mental illness, and recommendations for nursing practice. The report also includes a literature review on the topic.

Nursing assignment

1 | P a g e
Table of Contents
Introduction................................................................................................................................1
Metabolic Syndrome and SGA’s............................................................................................1
Second Generation Antipsychotic medications.........................................................................1
Use of Second Generation Antipsychotic medications..............................................................2
Side effects of SGA’s.............................................................................................................2
SGA’s are recommended........................................................................................................2
Literature review........................................................................................................................3
Pre-existing physical health status for people with mental illness.........................................4
Recommendations for nursing practice with people prescribed SGAs..................................4
Ethics..........................................................................................................................................5
Conclusion..................................................................................................................................7
References..................................................................................................................................8

2 | P a g e
Introduction
This report covers the discussion about the second generation antipsychotic. The
subject came into thought because of expanding utilization of prescriptions. The original
antipsychotics have been replaced by the second generation antipsychotics. They offer wide
assortment of advantages and have likewise lessened the reactions. This report covers the
solution techniques of second generation alongside its advantages. This report covers the
medication strategies of second along with its benefits. The side effects have also been listed
below.
Metabolic Syndrome and SGA’s
Metabolic Syndrome can be treated as a cluster of all the metabolic disorders. If a
patient is suffering from such illness there are chances that it may lead to future
cardiovascular disease. This disease arises mainly when there are chances of abdominal
obesity, greater triglyceride level, high cholesterol or high blood pressure (Al‐Nasiry, et. al,
2015). The risk of Metabolic Syndrome increases if there is presence of any such
abnormality. According to the research it can be stated that metabolic syndrome is strictly
linked with overweight or obesity in an individual. The risk of metabolic syndrome increases
with age, race, obesity, diabetes and various other illnesses (Lui, Randhawa, Totten, Smith &
Raese, 2016). The metabolic syndrome doesn’t have any signs of symptoms thus it adds up
more risk as there is no clear visibility. This is generally seen among those individual who
have higher weight. The kidneys can also be affected as there are chances of leaking of
protein that give a clear indication of kidney damage (Leite, et. al, 2017).
SGA’s is a new terminology that arrived after first generation. This covers various
drugs like chlorpromazine, haloperidol, fluphenazin and many others. If compared with the
first generation antipsychotics it has high efficacy (Hooijschuur, Ghossein-Doha, Al-Nasiry
& Spaanderman, 2015). The side effects have also been reduced due to the modified use of
drugs. The second generation antipsychotic is also known as Selective Serotonin Reuptake
Inhibitors that were introduced in the beginning of 1980s. The main motive of using SG is to
block all the receptors to pathways to cause any damage.

3 | P a g e
Second Generation Antipsychotic medications
The second generation medication has higher efficiency in terms of treatment from all
the diseases and it is powerful from overcoming from all the diseases. Second generation
antipsychotics can also be termed as a typical antipsychotics. They generally have lower risk
of side effects as compared to first generation antipsychotics. It is one of the powerful
techniques used to overcome from illness as it is different from other dosing administration.
They are mainly used in bipolar disorder, schizophrenia and acute agitation. They mainly
differ from old medications as it makes use of 5HT2 receptor which was not used in case of
first generation. The other benefits of using second generation antipsychotic are it binds all
the drugs to a receptor rather than binding them at a striatal area (Gerhard, et. al, 2014). They
are very powerful as they make patients independent and remove the disease. There are very
new medications that are approved like clozapine, risperidone and aripiprazole drugs. With
the innovation of these drugs the physical symptom like anxiety, paranoia has become less.
Use of Second Generation Antipsychotic medications
These are very useful as they are basically used to provide short term treatment for all
the disorder by controlling the symptoms. The symptoms can be very acute but second
generation treat the illness in a manner that they add long term value by preventing the
disease to last for long term. Thus it can be stated that they help in controlling all the positive
symptoms and second generation antipsychotic medications can help with the negative
symptoms also. They are essentially used for severe bipolar disorder severe depression.
Second generation is very beneficial in terms of dealing with antipsychotic. It safely details
the entire situation by taking care of which drugs should not be taken together. They can also
be used to treat serious mental illness as well as other conditions related to emotional
conditions (Nielsen, et. al, 2015). They are also useful as they reduce the effect on
neurosystem by removing all the delusions that is experienced. The main advantage of using
these drugs is that they improve the symptoms that lower the motivation. These medicines
have various side effects like it leads to headache, nausea, constipation which in turn leads to
increase in weight. It sometimes causes erection problem among men’s or disturbance in
woman’s menstrual cycle. This

4 | P a g e
Side effects of SGA’s
It is true that they offer benefits but they are various side effects that are caused due to
second generation antipsychotic. The side effect can be in term of agitation, blurred vision,
confusion, dry skin, nervousness, constipating, and excitement, raised pressure in eye,
delusions, fast heartbeat, rashes, difficulty sleeping, swallowing, hallucinations, thirst
difficulty, urinating, high temperature or vomiting (Pringsheim & Barnes, 2018). Second
generation antipsychotic may also lead to weight gain and can also cause high level of sugar
in the blood. Second generation antipsychotic medicines leads to development of neuroleptic
malignant syndrome that is a life threatening side effect. Initially there are symptoms of
fever, irregular heartbeats, rapid breathing and sweating (Semla, Lee, Gurrera, Bajor, Miller
& Bauer, 2017). The unwanted side effects that are caused of second generation antipsychotic
vary from drug to drug.
SGA’s are recommended
It is true that second generation antipsychotic have various side effects but still it is
prescribed to be used. It is recommended as it can be used in treatment with schizophrenia
and it also removes the side effects that are caused by first generation antipsychotic. They
also help in reducing symptoms of the medicines that are caused by first generation
antipsychotic. They are faster in terms of reacting to the illness and also help in reducing the
side effects of neuromuscular effect (Shiel, 2015). Being a nurse second generation
antipsychotic is prescribed as they are more effective in treating all the negative symptoms if
compared to other methods. They help in removing the risk factors and disorders. This risk is
increased even further if an unhealthy lifestyle is followed (Mirecc, 2015),. Generally it's
important that nurses assure that patients eat a healthy diet and get enough exercise.
Literature review
According to (Pilon, et. al, 2017), a mental illness is increasing day by day and it
leads to lower physical health. A person with poor physical health and mental health needs a
nurse to monitor the individual. Nurses access the patient by focusing on the prevention
methods and intervention of all the resources. Nurse focus on understanding the needs of an
individual related to mental health illness. It is important that mental health nurse work on
improving the physical health of patient this could be done by developing awareness
regarding all the obstacles to improve the physical health. It can be stated from the research
that people suffer from mental illness generally after the age of 25. The main reason of this

5 | P a g e
illness is side effect of antipsychotic medication or inactive lifestyle. Thus the main role of
nurses is to deal with the issues of patient and try to keep them busy. Medical nurses
predominantly get to know the person by enhancing the social insurance benefit and by
screening and observing every indication. They arrange and deal with the care of a person by
investing a large portion of the energy with them. They likewise convey way of life programs
by following up every one of the activities that they practice and after that alter them as
indicated by the necessities. There are different cases, considering a case in which the patient
was experiencing discouragement that had negative effect on this life, he was not able move
appropriately and take legitimate choices
In the views of (Sjo, Stenstrøm, Bojesen,Frølich & Bilenberg, 2017), role of nurses in
accessing the patient suffering from mental illness plays an important role. As nurses are
treated as a professional care department that support an individual by offering them health
care services and discovering recovery plans. They work on physical activities to show
positive effect on their life and removing the symptoms of depression and anxiety. It is true
that nurses led to physical health program for patients suffering from serious mental illness.
These programs help them in analysing the health scenario of an individual. Nurses mainly
access the individual by improving the health care service by screening and monitoring all the
symptoms. They coordinate and manage the care of an individual by spending most of the
time with them. They also deliver lifestyle programs by following up all the actions that they
practise and then modify them according to the needs (De Hert, et. al, 2015). There are
various examples, considering a case in which the patient was suffering from depression that
had negative impact on this life, he was unable to move properly and take proper decisions
(Ashp, 2015). Thus a proper care was provided by nurses by keeping him busy in the social
activities so that level of depression gets reduced.
Pre-existing physical health status for people with mental illness
People are suffering from mental illness they have more chances of increased physical
illness which also reduces the life expectancy. The people with mental illness suffer from low
mortality and morbidity factors. The mental illnesses affect the physical health of a person
due to low level of physical activities.
Physical health also plays an important role in impacting the mental health of a
person. Severe mental illness leads to heart disease. The research suggests that people
suffering from mental illness have higher risk of cardiovascular disease. There exist a double

6 | P a g e
sided link between physical health and mental illness but this is often misunderstood. Mental
illness is not a physical disease but this is related as mental illness has direct impact on
physical health. Some of the examples that cover mental illness are depression, anxiety
disorders, schizophrenia, eating disorders, and bipolar depression (Chaudhari, Otiv, Hoge,
Pandit & Sayyed, 2017). It is important to treat all the issues related to mental illness
otherwise it may lead to serious health issues such as heart disease, high blood pressure,
weakened immune system, asthma, obesity, gastronomically problems and premature death.
Thus mental illness could be improved by improving the physical health. This could be
achieved by exercising daily that makes possible that more mindful interactions could be
made. Other than it is recommended that healthy diet is taken and a proper sleeping
scheduled is followed. It can be stated that poor physical health leads to risk in mental illness
problems. In the same way poor mental health have negative impact on physical health of an
individual (Christian, et. al, 2015). It can be stated that poor mental illness increases the risk
of physical illness which can be improved eating healthy, spending time with those friends
and family who care about their wellbeing, set goals that are realistic and achievable and by
supporting an individual by being their mentor. Thus the main part of second generation
antipsychotic is patient education so that they are aware of all the adverse effects that can be
caused by these drugs. It is the duty of nurses to manage all the adverse effect by stopping all
the antipsychotic effect.
Recommendations for nursing practice with people prescribed SGAs
The nursing practise includes defining all the terms that would be required. Nurses
also outline appropriate groups that could be used for advanced clearance. The role of nurse’s
n different for advances secretion techniques. The patient who is suggested take second
generation antipsychotic should check the doze of tablets as they have poor effect on the
blood cells. It is recommended that before prescribing the medicines regular blood test need
to be done. Apart from that blood sample is tested before starting the treatment. The
monitoring of all the body organs is done so that no wrong recommendation is done. The test
helps the nurses in analysing the number of blood cells, to check that kidney and liver is
working properly. Apart from that it I important to take proper nurses care before taking any
tablets as second generation antipsychotic drugs can affect thinking. Thus it is recommended
that nurse’s should take care of all the patients that face the side effects by using these
medicines. Thus for nurses it is recommended that they consider patients safety at priority.
This can be by done by implicating safety rules for the patients who are receiving

7 | P a g e
antipsychotic assessment of all the ability and signs. Additionally with the information of all
the prescribed medicines warning is given regarding all the problems and interventions.
Frequent and constant monitoring is essential for individuals treated with antipsychotics in
order to measure for therapeutic response and adverse effects (Bauer, Lee, Bajor, Rasmusson
& Kazis, 2014). For the second-generation antipsychotics it is recommended that minimum
trial duration is given that is three weeks after adjustment of the entire dose.
Thus it is recommended that all patients accepting second-age antipsychotics should
be checked for indications of dystonia. Patients need to be assessed for intense
extrapyramidal side effects week by week at least for two weeks after measurement
adjustment when antipsychotics are started. Appraisals for the medicines lead in any event
once yearly for people getting nonstop treatment with antipsychotics (Carbon, Hsieh, Kane
& Correll, 2017). This helps in identifying all the side effects so that measures could be taken
accordingly.
Ethics
There exist some of the ethical principles that help in minimising the unwanted
effects of Second generation antipsychotic medications. It is true that there exist various
side-effects but still they are used as they have fewer side effects as compared to second-
generation antipsychotics. These are beneficial as it eliminates the negative symptoms and
also enhances positive impact of schizophrenia (Arango, et. al, 2014). The effect of second
generation antipsychotic can be minimised by undergo comprehensive health check of a
patient before an antipsychotic is prescribed. The risk can be avoided if all the drug s and the
therapy of an individual are designed by considering all the pre-existing symptoms (Jibson,
2016). The side effects can be reduced by implicating proper treatment like effects on social
functioning that need to be analysed before initiating therapy with the patient (Coughlin,
Goldie, Tranmer, Khalid & Tregunno, 2018). The ethical principal states that patients should
be frequently monitored for checking the side effects during and after the treatment. The
alternative therapy need to be designed so that it is persistent.
The moral standards express that patients ought to be offered ideal to be educated about every
one of the impacts and they ought to be effectively mindful about the social insurance. The
mental care act states that a person’s self-esteem and independence helps in making decisions
so that treatment could be done by refusing unwanted treatments and providing proper

8 | P a g e
prevention methods. According to the research it is suggested that awareness regarding all the
ethical reinforcements of consent and authorized requirements related to the treatment need to
be discussed (Bahr, et. al, 2015). The treatment changes over time and may differ according
to different conditions and circumstances.
The side effect of SG can be minimised by working according to the suggestion even by
doctors. The dizziness and headache could be enhanced by proposing patient to drink a lot of
water and maintain a strategic distance from all the liquor drinks. The prescriptions ought to
be gone up against normal premise all of a sudden halting the solution can prompt
unfavourable impact (Cohen, et. al, 2015). If the medication has a sever side effect it can
easily be coped up by changing the does that it recommended and trying to get the optimum
dose. The high dose symptom leads to have serious effect on the life patient. The medication
should be taken on regular basis to avoid the adverse effect of medication. There are varieties
of anti-anxiety drugs that are available to remove the side effect of the SG (Wang, Huang,
Feng & Tsuang, 2018).

9 | P a g e
Conclusion
It can be concluded from this report that second generation lowers the risk of side
effects and have faster effect on the recovery. The medications should be taken by legitimate
proposal from the specialists as they incorporate different reactions moreover. They offer
various benefits by taking care of which combination of drugs should not be taken together to
avoid the chances of future side effects. It is prescribed by the vast majority of the specialists
to utilize SG ha it has less reactions in addition to they are more successful. The literature
review covers how wellbeing medical caretakers should access and screen the physical
strength of administration clients. The exploration is done on the previous physical wellbeing
status for individuals alongside their psychological maladjustment. The covers how health
nurses should access and monitor the physical health of service users. The research is done on
the pre-existing physical health status for people along with their mental illness. This report
also covers the ethical principles regarding the practice that will help them to minimise the
unwanted effects of SG has also been discussed. Thus it can be stated that physical health
additionally assumes an imperative part in affecting the emotional wellness of a man.

10 | P a g e
References
Al‐Nasiry, S., Ghossein‐Doha, C., Polman, S. E. J., Lemmens, S., Scholten, R. R., Heidema,
W. M., ... & Spaanderman, M. E. A. (2015). Metabolic syndrome after pregnancies
complicated by pre‐eclampsia or small‐for‐gestational‐age: a retrospective
cohort. BJOG: An International Journal of Obstetrics & Gynaecology, 122(13), 1818-
1823.
Arango, C., Giráldez, M., Merchán-Naranjo, J., Baeza, I., Castro-Fornieles, J., Alda, J. A., ...
& de la Serna, E. (2014). Second-generation antipsychotic use in children and
adolescents: a six-month prospective cohort study in drug-naïve patients. Journal of
the American Academy of Child & Adolescent Psychiatry, 53(11), 1179-1190.
Ashp therapeutic position statements. (2015). ASHP Therapeutic Position Statement on the
Use of Second-Generation Antipsychotic Medications in the Treatment of Adults with
Psychotic Disorders. Retrieved from https://www.ashp.org/-/media/assets/policy-
guidelines/docs/therapeutic-position-statements/use-second-generation-
antipsychotic.ashx?
la=en&hash=B38B3096B6D75649DD7D190E7EBE468C7DBAD052.
Bahr, S. M., Tyler, B. C., Wooldridge, N., Butcher, B. D., Burns, T. L., Teesch, L. M., ... &
Calarge, C. A. (2015). Use of the second-generation antipsychotic, risperidone, and
secondary weight gain are associated with an altered gut microbiota in
children. Translational psychiatry, 5(10), e652.
Bauer, M. S., Lee, A., Li, M., Bajor, L., Rasmusson, A., & Kazis, L. E. (2014). Off‐label use
of second generation antipsychotics for post‐traumatic stress disorder in the
Department of Veterans Affairs: time trends and sociodemographic, comorbidity, and
regional correlates. Pharmacoepidemiology and drug safety, 23(1), 77-86.
Carbon, M., Hsieh, C. H., Kane, J. M., & Correll, C. U. (2017). Tardive Dyskinesia
Prevalence in the Period of Second-Generation Antipsychotic Use: A Meta-Analysis.
Chaudhari, S., Otiv, M., Hoge, M., Pandit, A., & Sayyed, M. (2017). Components of
metabolic syndrome at 22 years of age–findings from Pune Low Birth Weight
Study. Indian pediatrics, 54(6), 461-466.

11 | P a g e
Christian, R. B., Gaynes, B. N., Saavedra, L. M., Sheitman, B., Wines, R., Jonas, D. E., ... &
Carey, T. S. (2015). Use of antipsychotic medications in pediatric and young adult
populations: future research needs. Journal of Psychiatric Practice®, 21(1), 26-36.
Cohen, L. S., Viguera, A. C., McInerney, K. A., Freeman, M. P., Sosinsky, A. Z., Moustafa,
D., ... & Chitayat, D. (2015). Reproductive safety of second-generation
antipsychotics: current data from the Massachusetts General Hospital National
Pregnancy Registry for Atypical Antipsychotics. American Journal of
Psychiatry, 173(3), 263-270.
Coughlin, M., Goldie, C. L., Tranmer, J., Khalid-Khan, S., & Tregunno, D. (2018). Patient,
Treatment, and Health Care Utilization Variables Associated with Adherence to
Metabolic Monitoring Practices in Children and Adolescents Taking Second-
Generation Antipsychotics. The Canadian Journal of Psychiatry, 63(4), 240-249.
De Hert, M., Sermon, J., Geerts, P., Vansteelandt, K., Peuskens, J., & Detraux, J. (2015). The
use of continuous treatment versus placebo or intermittent treatment strategies in
stabilized patients with schizophrenia: a systematic review and meta-analysis of
randomized controlled trials with first-and second-generation antipsychotics. CNS
drugs, 29(8), 637-658.
Gerhard, T., Akincigil, A., Correll, C. U., Foglio, N. J., Crystal, S., & Olfson, M. (2014).
National trends in second-generation antipsychotic augmentation for nonpsychotic
depression. The Journal of clinical psychiatry, 75(5), 490-497.
Hooijschuur, M. C., Ghossein-Doha, C., Al-Nasiry, S., & Spaanderman, M. E. (2015).
Maternal metabolic syndrome, preeclampsia, and small for gestational age
infancy. American Journal of Obstetrics & Gynecology, 213(3), 370.
Jibson, M. D. (2016). Second-generation antipsychotic medications: Pharmacology,
administration, and side effects. UpToDate. Waltham, MA (accessed 12 January
2017).
Leite, P. B., Dâmaso, A. R., Poli, V. S., Sanches, R. B., Silva, S. G. A., Fidalgo, J. P. N., ... &
Caranti, D. A. (2017). Long-term interdisciplinary therapy decreases symptoms of
binge eating disorder and prevalence of metabolic syndrome in adults with
obesity. Nutrition Research, 40, 57-64.

12 | P a g e
Lui, K., Randhawa, G., Totten, V., Smith, A. E., & Raese, J. (2016). Is Metabolic Syndrome
On the Radar? Improving Real-Time Detection of Metabolic Syndrome and Physician
Response by Computerized Scan of the Electronic Medical Record. The primary care
companion for CNS disorders, 18(1).
Mirecc. (2015). https://www.mirecc.va.gov/visn22/
Facts_about_Antipsychotic_Medications_Veteran_and_Family_Handout.pdf. Retriev
ed from
https://www.mirecc.va.gov/visn22/Facts_about_Antipsychotic_Medications_Veteran
_and_Family_Handout.pdf.
Nathan, P. E., & Gorman, J. M. (Eds.). (2015). A guide to treatments that work. Oxford
University Press.
Nielsen, R. E., Levander, S., Kjaersdam Telleus, G., Jensen, S. O. W., Östergaard
Christensen, T., & Leucht, S. (2015). Second‐generation antipsychotic effect on
cognition in patients with schizophrenia—a meta‐analysis of randomized clinical
trials. Acta Psychiatrica Scandinavica, 131(3), 185-196.
Pilon, D., Joshi, K., Tandon, N., Lafeuille, M. H., Kamstra, R. L., Emond, B., & Lefebvre, P.
(2017). Treatment patterns in Medicaid patients with schizophrenia initiated on a first-
or second-generation long-acting injectable versus oral antipsychotic. Patient
preference and adherence, 11, 619.
Pringsheim, T., & Barnes, T. R. (2018). Antipsychotic Drug-Induced Movement Disorders: A
Forgotten Problem?. The Canadian Journal of Psychiatry.
Semla, T. P., Lee, A., Gurrera, R., Bajor, L., Li, M., Miller, D. R., ... & Bauer, M. S. (2017).
Off‐Label Prescribing of Second‐Generation Antipsychotics to Elderly Veterans with
Posttraumatic Stress Disorder and Dementia. Journal of the American Geriatrics
Society, 65(8), 1789-1795.
Shiel. W. (2015). Metabolic Syndrome. Retrieved from
https://www.medicinenet.com/metabolic_syndrome/article.htm#why_should_i_know
_about_metabolic_syndrome.
Sjo, C. P., Stenstrøm, A. D., Bojesen, A. B., Frølich, J. S., & Bilenberg, N. (2017).
Development of Metabolic Syndrome in Drug-Naive Adolescents After 12 Months of

13 | P a g e
Second-Generation Antipsychotic Treatment. Journal of child and adolescent
psychopharmacology, 27(10), 884-891.
Wang, H. Y., Huang, C. L. C., Feng, I. J., & Tsuang, H. C. (2018). Second-generation
antipsychotic medications and risk of chronic kidney disease in schizophrenia:
population-based nested case–control study. BMJ open, 8(5), e019868.