ATYPICAL ANTIPSYCHOTICS: New Directions and New Challenges in the Treatment of Schizophrenia
"Atypical" antipsychotics represent a new generation of antipsychotics with a significantly lower incidence of extrapyramidal side effects (EPS), as well as little or no effect on prolactin elevation. These advantages constitute a major improvement in the treatment of patients with schizop...
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Published in | Annual review of medicine Vol. 52; no. 1; pp. 503 - 517 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
Palo Alto, CA 94303-0139
Annual Reviews
01.01.2001
4139 El Camino Way, P.O. Box 10139 Annual Reviews, Inc USA |
Subjects | |
Online Access | Get full text |
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Summary: | "Atypical" antipsychotics represent a new generation of
antipsychotics with a significantly lower incidence of extrapyramidal side
effects (EPS), as well as little or no effect on prolactin elevation. These
advantages constitute a major improvement in the treatment of patients with
schizophrenia. The exact mechanisms that make these drugs atypical is not
clear. However, a preferential action on serotonin 5-HT
2
or
D
4
receptors, or a more rapid dissociation from the dopamine
D
2
receptor, may account for atypicality. Although the atypical
antipsychotics have overcome EPS, other side effects such as weight gain and
impaired glucose tolerance/lipid abnormalities have come to the fore. Thus, the
challenges are far from over. The current atypicals are much more effective
against the psychosis of schizophrenia than against the other, more enduring
aspects of this disorder, e.g. negative symptoms and cognitive dysfunction. At
present, the atypicals use a "pharmacological shotgun" strategy to
treat aspects of the disease in all patients. A more sophisticated and perhaps
effective approach to schizophrenia may lie in independently targeting the
pathophysiological mechanisms of each clinical dimension (i.e. positive,
negative, cognitive, and affective) with more selective drugs that can be
combined and individually titrated to the needs of each patient. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 |
ISSN: | 0066-4219 1545-326X |
DOI: | 10.1146/annurev.med.52.1.503 |