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Review

Atypical antipsychotics in the treatment of schizophrenic patients

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Pages 355-362 | Published online: 10 Jan 2014

References

  • Davies LM and Drummond ME Economics and schizophrenia: the real cost. Br.Psychiatry 25 (Suppl.), 18–21 (1994).
  • Knapp M. Cost of schizophrenia. Br. Psychiatry171,509–518 (1997).
  • Rice DP. The economic impact of schizophrenia. j Clin. Psychiatry60,4–6 (1999).
  • Jablensky A. Epidemiology of schizophrenia: the global burden of disease and disability. Eur. Arch. Psychiatry Clin. Neurosci. 250,274–285 (2000).
  • Egan MF, Hyde TM. Schizophrenia: Neurobiology. In: Kaplan & Saddock's Comprehensive Textbook of Psychiatry Saddock BJ, Saddock VA (Eds). Lippincott, Philadelphia, USA 1129–1146 (2000).
  • Andreasen N. A unitary model of schizophrenia. Arch. Gen. Psychiatry 56 781–787 (1999).
  • Abi-Dargham A, Rodenhiser J, Printz D et al. Increased baseline occupancy of D2 receptors by dopamine in schizophrenia. Proc. Natl Acad. Sci. USA 97,8104–8109 (2000).
  • Naber D, Lambert M, Krausz M, Haasen C. Atypical antipsychotics in the treatment of schizophrenic patients. UNI-MED Verlag, Bremen, Germany, Boston, USA (2002).
  • McEvoy JP, Scheifler PL, Frances A. The Expert Consensus Guideline Series: Treatment of schizophrenia. j Clin. Psychiatry 60 (Suppl. 11), (1999).
  • ••Very helpful guideline for the treatment ofschizophrenia. Apart from recommendations concerning the use of antipsychotic drugs (including the probability of certain side effects, dosage, comedication, screening tests) there are also criteria for hospitalization or outpatient services and recommendations for psychosocial interventions.
  • Kane JM. Management strategies for the treatment of schizophrenia. j Clin. Psychiatry60 (Suppl. 12), 13–17 (1999).
  • Csernansky JG, Mahmoud R, Brenner R et al. A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. N Engl. Med. 346,16–22 (2002).
  • •Huge multicenter study with 397 schizophrenic patients showing that patients treated with risperidone have a significantly lower risk of relapse (37%) compared to patients under haloperidol (60%) within 1 year. To our knowledge, this is the first study that proved a better efficacy of a atypical antipsychotic drug in the prevention of relapse in patients with schizophrenia.
  • Dolder CR, Lacro JP, Dunn LB, Jeste DV Antipsychotic medication adherence: is there a difference between typical and atypical agents? Am. j Psychiatry 159,103–108 (2002).
  • •First study to show higher compliance in patients with schizophrenia treated with risperidone, olanzapine or quetiapine, compared to patients treated with haloperidol or perphenazine during a 1-year period. Remarkably, the hospital policy at the time of this study required failure in trials of at least two typical antipsychotics before initiation of an atypical agent. Thus, there might have been even higher rates of compliance in the group with atypical drugs because more patients with treatment-resistant illness and more treatment-intolerant patients may have had prescriptions for atypical agents.
  • Chakos M, Liebermann J, Hoffman E et al. Effectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: a review and meta-analysis of randomized trials. Am. Psychiatry158,518–526 (2001).
  • Keefe R, Silva S, Perkins D, Lieberman J. The effects of atypical antipsychotic drugs in neurocognitive impairment in schizophrenia: a review and meta-analysis. Schizophr. Bull. 25,201–222 (1999).
  • ••This meta-analysis included studiesbetween 1990 and 1998 and concludes that the atypical antipsychotics are significantly more effective than conventional antipsychotics at improving cognitive function. It also provides a discussion of the possible pharmacological mechanisms of both beneficial and detrimental effects of the various antipsychotics on cognitive function.
  • Meltzer HY, McGurk SR. The effects of clozapine, risperidone and olanzapine on cognitive function in schizophrenia. Schizophr. Bull. 25,233–255 (1999).
  • •Interesting review that discusses the effects of clozapine, olanzapine and risperidone on cognitive functioning. The most consistent findings are that clozapine improves verbal fluency and attention and might also improve some types of executive functions. Results of the effects of clozapine on working memory and secondary verbal and spatial memory were inconclusive. Risperidone has relatively consistent positive effects on working memory, executive functioning and attention, whereas improvement in verbal learning and memory was inconsistent. In their opinion, preliminary evidence suggests that olanzapine improves verbal learning and memory, verbal fluency and executive function, but not attention, working memory, or visual learning and memory.
  • Drake RE, Ehrlich J. Suicide attempts associated with akathisia. Am. j Psychiatry 142,499–501 (1985).
  • Otte C, Naber D. Compliance in der Therapie mit Neuroleptika, Antidepressiva und Lithium. Bundesgesundheitsblatt 44, 14–19 (2001).
  • Fenton WS, Blyler CR, Heinssen Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizoplzr: Bull. 23,637–651 (1997).
  • •• Excellent review focusing on criteria of medication compliance in schizophrenic patients. However, data concerning differences between atypical and conventional neuroleptics are not included due to a lack of such studies at that time.
  • Allison DB, Mentore JL, Heo M et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am. Psychiatry 156,1686–1696 (1999).
  • Naber D, Moritz S, Lambert M et al. Improvement of schizophrenic patients' subjective well-being under atypical antipsychotic drugs. Schizophr. Res. 50,79–88 (2001).
  • Henderson DC, Cagliero EC, Gray C et al. Clozapine, diabetes mellitus, weight gain and lipid abnormalities: a five-year naturalistic study. Am. j Psychiatry157, 975–981 (2000).
  • Lund BC, Perry PJ, Brooks JM, Arndt S. Clozapine use in patients with schizophrenia and the risk of diabetes, hyperlipidemia and hypertension. Arch. Gen. Psychiatry58,1172–1176 (2001).
  • Alvir JMJ, Liebermann J, Saffermann AZ, Schwimmer JL, Schaaf JA. Clozapine-induced agranulocytosis. Incidence and risk factors in the United States. N Engl. Med. 329,162–169 (1993).
  • Mackay FL Wilton LV, Pearce GL, Freemantle SN, Mann RD. The safety of risperidone: a post marketing study on 7,684 patients. Hum. Psychopharmaco1 13, 413–418 (1998).
  • Arnt J. Pharmacological differentiation of classical and novel antipsychotics. Int. Clin. Psychopharmacol 13\(Suppl. 1), 43–49 (1998).
  • Kasper S, Hale A, Azorin JM, Moller HJ. Benefit-risk evaluation of olanzapine, risperidone and sertindole in the treatment of schizophrenia. Eur. Arch. Psychiatry Clin. Neurosci. 249\(Suppl. 2), 2–14 (1999).
  • Richelson E. Receptor pharmacology of neuroleptics: relation to clinical effects. J. Clin. Psychiatry 60 (Suppl. 10), 5–14 (1999).
  • Barnes TR, Joyce EM. Antipsychotic drug treatment. Recent advances. CUIT: Opin. Psychiatry14, 25–37 (2001).
  • Remington G, Kapur S. Atypical antipsychotics: are some more atypical than others? Psychopharmacology148, 3–15 (2000).

Websites

  • •• All Cochrane reviews listed below are of great interest because they summarize the available empirical findings concerning different antipsychotic medication in the treatment of schizophrenia.
  • Wahlbeck K, Cheine M, Essali MA. Clozapine versus typical neuroleptic medication for schizophrenia (Cochrane Review). www.cochranelibrary.com (2002).
  • Duggan L, Fenton M, Dardennes RM et al. Olanzapine for schizophrenia. (Cochrane Review). www.cochranelibrary.com (2002).
  • Kennedy E, Song F, Hunter R et al. Risperidone versus typical antipsychotic medication for schizophrenia. (Cochrane Review). www.cochranelibrary.com (2002).
  • Bagnall AM, Lewis RA, Leitner ML et al. Ziprasidone for schizophrenia and severe mental illness. (Cochrane Review). www.cochranelibrary.com (2002).
  • Srisurapanont M, Disayavanish C, Taimkaew K. Quetiapine for schizophrenia. (Cochrane Review). www.cochranelibrary.com (2002).
  • Tuunainen A, Wahlbeck K, Gilbody SM. Newer atypical antipsychotic medication versus clozapine for schizophrenia (Cochrane Review). www.cochranelibrary.com (2002).
  • Fenton M, Morris S, DeSilva P et al. Zotepine for schizophrenia. (Cochrane Review). www.cochranelibrary.com (2002).
  • Gilbody SM, Bagnall AM, Duggan L et al. Risperidone versus other atypical antipsychotic medication for schizophrenia. (Cochrane Review). www.cochranelibrary.com (2002). Affiliations

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