Antipsychotics from theory to practice:
integrating clinical and basic data

by
Tandon R, Milner K, Jibson MD
University of Michigan Medical Center,
Ann Arbor 48109-0120, USA.
rtandon@umich.edu
J Clin Psychiatry 1999; 60 Suppl 8:21-8


ABSTRACT

The recent introduction of the atypical antipsychotics into the treatment arena for psychoses and related disorders comes with justifiable excitement. These newer antipsychotics offer several clinical benefits over the conventional antipsychotics, which have been the mainstays of care thus far. The primary advantage of these atypical agents is their superior side effect profiles, particularly with regard to extrapyramidal side effects (EPS). The implications from a reduction in EPS touch on virtually every aspect of pathology in schizophrenic illness, including short- and long-term movement disorders, negative symptoms, noncompliance, cognitive dysfunction, and dysphoria. It should be emphasized that while atypical antipsychotics share many clinical attributes, there are also substantial differences among them. This review will examine the pharmacology, clinical efficacy, and side effect profiles of the atypical antipsychotics and attempt to relate the attributes observed in clinical practice and clinical trials to their basic pharmacologic profiles. There is a fair, but not perfect, correspondence between the pharmacologic profiles of the different atypical antipsychotics and their respective clinical attributes. After a comparative overview of their receptor-binding profiles, a brief pharmacokinetic summary will be provided. Finally, the clinical profiles of these agents will be summarized with regard to both their efficacy and adverse effects.
Zotepine
Clozapine
Quetiapine
LY2140023
Olanzapine
Risperidone
Trimipramine
Antipsychotics
Chlorpromazine
The deficit syndrome
Antipsychotics: review
Schizoaffective disorder
Bipolars and schizophrenics
Anhedonia and schizophrenia
Atypical antipsychotic agents
Partial dopamine agonists for psychosis
Big Pharma and drugs for schizophrenics
Atypical antipsychotics for schizophrenia
Diminished pain sensitivity in schizophrenia
Prescribing anti-psychotics to control children

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