Other Pharmacological Actions

Antipsychotic drugs produce shifts in the pattern of electrographic (EEG) frequencies, usually slowing them and causing hypersynchrony. This slowing is sometimes focal or unilateral, which may pose diagnostic problems, but the frequency and amplitude changes are readily apparent. The hypersynchrony produced by these drugs probably accounts for their activating effect on the EEG in epileptic patients and for the low incidence of seizures in patients with no history of seizure disorders.

Antipsychotics produce striking effects on the reproductive system. Amenorrhea and increased libido have been reported in women, whereas decreased libido and gynecomastia have been observed in men. Some of these actions are undoubtedly the result of a drug-associated blockade of dopamine's tonic normal inhibition of prolactin secretion, but they may also be partially due to an enhanced peripheral conversion of androgens to estrogens.

Orthostatic hypotension and high resting pulse rates can result from the use of the low-potency phenothi-azines. Mean arterial pressure, peripheral resistance, and stroke volume are decreased, while pulse rate is increased. Abnormal electrocardiograms (ECGs) have been observed, especially following thioridazine administration. These findings include prolongation of the QT interval and abnormal configurations of the ST segment and T waves, the latter being rounded, flattened, or notched. These effects are readily reversed upon drug withdrawal.

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