The detrimental effects of alcohol on the skills related to driving are greatly increased by chlorpromazine, increased by flupentixol and thioridazine, and possibly increased by olanzapine, prochlorperazine and quetiapine. Any interaction with amisulpride, haloperidol, sulpiride or tiapride seems to be mild. The postural hypotension seen with antipsychotics is likely to be worsened by alcohol. There is evidence that drinking can precipitate extrapyramidal adverse effects in patients taking antipsychotics.
It has been suggested that patients should routinely be advised to abstain from alcohol during antipsychotic treatment in order to avoid potentiating extrapyr- amidal adverse effects, although note that cases of a problem seem rare. The degree of sedation will depend on the antipsychotic given and the individual patient. However, warn all patients of the potential effects, and counsel against driving or undertaking other skilled tasks. Patients should also be warned about postural hypotension and counselled on how to manage it (i.e. lay down, raise the legs, and on recovering to get up slowly).
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