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Ann Pharmacother. 1999 Jan;33(1):73-85.

Atypical antipsychotics. Part I: Pharmacology, pharmacokinetics, and efficacy.

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  • 1Department of Pharmaceutical Sciences, Medical University of South Carolina, Charleston, USA.

Abstract

OBJECTIVE:

To compare the pharmacology, pharmacokinetics, and efficacy of the newer atypical antipsychotics with those of conventional agents and existing atypical agents.

DATA SOURCES:

Information was retrieved from a MEDLINE English-literature search from July 1986 to June 1998 and by review of references. Indexing terms included neuroleptics, atypical antipsychotics, clozapine, risperidone, olanzapine, sertindole, quetiapine, and ziprasidone.

STUDY SELECTION:

Comparative studies were selected when possible; placebo-controlled studies were included when data were limited on newer atypical antipsychotics.

DATA EXTRACTION:

Emphasis was placed on properly designed clinical trials that assessed dosage, expanded efficacy, enhanced adverse effect profile, and cost.

DATA SYNTHESIS:

Like other atypical antipsychotics, the newer agents have an enhanced 5-hydroxytryptophan/dopaminergic receptors (5-HT2/D2) affinity ratio and undergo extensive biotransformation. Risperidone and olanzapine demonstrate more favorable efficacy/adverse effect ratios than clozapine, sertindole, and conventional antipsychotics in nonrefractory and refractory schizophrenics. Future studies will more clearly define the role of quetiapine and ziprasidone in antipsychotic therapy.

CONCLUSIONS:

Data from controlled trials on efficacy and extrapyramidal side effects support risperidone or olanzapine as first-line agents for the treatment of schizophrenia. Pharmacologic and pharmacokinetic factors do not distinguish between agents sufficiently for drug selection.

PMID:
9972387
[PubMed - indexed for MEDLINE]
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