> First, the adverse effects of antipsychotic medications are widely attested and very serious. They fall into at least two classes: cognitive impairments, and extrapyramidal disorders (such as akathisia, parkinsonism, and tardive dyskinesia). Both are concerning.
> Increasing evidence, both anecdotal and studied, suggests that antipsychotics frequently impair cognitive functioning. This is often described by those who have suffered from it as “zombie-like”, or as though they lacked the capacity for abstract thought [1]. There is a large empirical literature giving rigorous backing to these informal reports (see [2] for an overview and bibliography); more specifically, much of this literature suggests that antipsychotics can seriously impair procedural learning [3] [4] [9]. These empirical findings in the scientific literature, while plentiful and robust, seem not to have fully percolated yet into clinical practice.
> In addition to their potential adverse cognitive effects, antipsychotic medications are well-known to carry the risk of painful, disabling, and potentially damaging motor (“extrapyramidal”) disorders. These include akathisia (commonly described by those to experience it as “torture”), parkinsonism (a collection of symptoms similar to those involved in Parkinson’s Disease), and tardive dyskinesia (a chronic and unremitting motor disorder resulting from long-term use of antipsychotics) [5] [6] [7] [8]. While these conditions are common generally among users of antipsychotics (for those taking haloperidol—a commonly prescribed antipsychotic—extrapyramidal symptoms may present at or above fifty percent [10]), there is evidence they may be especially likely and severe, even at low doses, for autistic people [11] [12].
[1] Medical Xpress, “Antipsychotic meds prompt zombie-like state among patients” 5 Feb 2015 https://medicalxpress.com/news/2015-02-antipsychotic-meds-prompt-zombie-like-state.html
[2] Sarah Constantin, “Antipsychotics Might Cause Cognitive Impairment” 14 Jan 2018 https://www.sarah-constantin.org/blog/2018/1/14/antipsychotics-might-cause-cognitive-impairment
[3] Psychopharmacology, “Procedural learning in schizophrenia after 6 months of double-blind treatment with olanzapine, risperidone, and haloperidol” Sep 2003 https://pubmed.ncbi.nlm.nih.gov/12827347/
[4] Neuropsychopharmacology, “Effects of risperidone on procedural learning in antipsychotic-naive first-episode schizophrenia” Jan 2009 https://pubmed.ncbi.nlm.nih.gov/18536701/
[5] Missd, “The Agony of Akathisia” 6 Dec 2015 https://missd.co/256/
[6] National Commission on Correctional Health Care, “Akathisia: A Mysterious Medication-Induced Movement Disorder” 19 Jul 2021 https://www.ncchc.org/akathisia-a-mysterious-medication-induced-movement-disorder/
[7] Cleveland Clinic, “Parkinsonism” https://my.clevelandclinic.org/health/diseases/22815-parkinsonism#symptoms-and-causes
[8] National Library of Medicine, “Tardive Dyskenisia” 16 Aug 2022 https://www.ncbi.nlm.nih.gov/books/NBK448207/
[9] Journal of Psychiatric Research, “Effects of haloperidol and risperidone on psychomotor performance relevant to driving ability in schizophrenic patients compared to healthy controls” Jan 2005 https://pubmed.ncbi.nlm.nih.gov/15504428/
[10] MedicineNet, “Side effects of Haldol (haloperidol)” https://www.medicinenet.com/side_effects_of_haloperidol/side-effects.htm#haldol_haloperidol_side_effects_list_for_healthcare_professionals
[11] Spectrum News, “The missing generation” 9 Dec 2015 https://www.spectrumnews.org/features/deep-dive/the-missing-generation/
[12] Journal of Neurodevelopmental Disorders, “High rates of parkinsonism in adults with autism” 30 Aug 2015 https://jneurodevdisorders.biomedcentral.com/articles/10.1186/s11689-015-9125-6