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Do the New Antipsychotics Make A Difference? |
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Written by HealthyPlace.com Staff Writer
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Oct 17, 1999 |
A + A - RESET
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Page 2 of 4
Selected features of new antipsychotic drugs
| Drug (dose) |
Study |
Findings |
| Clozapine (200-800mg/day) versus traditional antipsychotic drugs |
Cochrane review[11] 29 studies based 2490 participants |
Effective antipsychotic, fewer relapses, greater reduction in symptoms, fewer drop-outs greater patient satisfaction satisfaction |
| Risperidone (2-6mg/day) versus traditional antipsychotic drugs |
Cochrane review[14] 14 studies based on 3401 participants |
Effective antipsychotic, greater clinical improvement little no additional effect positive or negative symptoms, fewer drop-outs |
| Olanzapine (10-20mg/day) versus traditional antipsychotic drugs |
Cochrane review[17] 5 studies based on 2911 participants |
Effective antipsychotic, fewer drop-outs, lower depression scores, less sedation, fewer extrapyramidal side effects |
| Sertindole (12-20mg/day) versus traditional antipsychotic drugs |
Randomised controlled trials[9] |
Effective antipsychotic, fewer extrapyramidal side effects |
| Ziprasidone (80-160mg/day) versus traditional antipsychotic drugs |
Randomised controlled trials[6] |
Effective antipsychotic, fewer extrapyramidal side effects |
| Quetiapine (300-450mg/day) versus traditional antipsychotic drugs |
Cochrane review[17] 6 trials based on 1417 participants |
Effective antipsychotic, fewer extrapyramidal side effects |
| Drug (dose) |
Selected side effects |
| Clozapine (200-800mg/day) versus traditional antipsychotic drugs |
Sedation, hypersalivation, weight gain, increased risk of convulsions at higher doses, 1% risk of agranulocytosis |
| Risperidone (2-6mg/day) versus traditional antipsychotic drugs |
Weight gain, hyperprolactinaemia (leading to amenorrhoea, galactorrhea, impotence), postural hypotension |
| Olanzapine (10-20mg/day) versus traditional antipsychotic drugs |
Sedation, weight gain, dizziness |
| Sertindole (12-20mg/day) versus traditional antipsychotic drugs |
Increased risk of QT interval prolongation (1.7% of patients) |
| Ziprasidone (80-160mg/day) versus traditional antipsychotic drugs |
Sedation |
| Quetiapine (300-450mg/day) versus traditional antipsychotic drugs |
Dizziness, dry mouth, sedation |
| Drug (dose) |
Comments |
| Clozapine (200-800mg/day) versus traditional antipsychotic drugs |
Patients require regular haematological monitoring, 31% of patients with schizophrenia previously resistant to drug treatment have clinical improvement |
| Risperidone (2-6mg/day) versus traditional antipsychotic drugs |
Lacks anticholinergic properties, patients switched from older antipsychotics (which often required ) the coprescription of anticholinergics to reduce extrapyramidal side effects to risperidone can undergo cholinergic rebound (flu-like symptoms) |
| Olanzapine (10-20mg/day) versus traditional antipsychotic drugs |
Transient elevation of hepatic transaminases, lower incidence of tardive dyskinesia compared with haloperidol |
| Sertindole (12-20mg/day) versus traditional antipsychotic drugs |
Baseline and regular ECG monitoring recommended, should be avoided in patients taking drugs known to prolong the QT interval, contraindicated in patients with clinically significant cardiovascular disease, now under review because ECG changes noted in some patients |
| Ziprasidone (80-160mg/day) versus traditional antipsychotic drugs |
Weight gain has not been a prominent feature of treatment with ziprasidone as compared with clozapine, risperidone, and olanzapine |
| Quetiapine (300-450mg/day) versus traditional antipsychotic drugs |
High drop-out rates in the trials limit interpretation |
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Last Updated( Feb 06, 2009 )
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reviewed by: Harry Croft, MD
Psychiatrist, HealthyPlace.com Medical Director
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