Antipsychotics in clinical practice: guidelines for safe and effective use

Abstract

Antipsychotic drugs have made a significant contribution to the treatment of schizophrenia but the older drugs in particular have significant side-effects. The newer atypical drugs are effective for the treatment of both positive and negative symptoms and they also have significantly fewer serious side-effects. However, these drugs are considerably more expensive that the older drugs and this has generated intense debate about their cost effectiveness. There is now good evidence that when all factors are taken into consideration the atypical drugs are both cost effective and improve the quality of life of patients with schizophrenia. Despite the importance of these drugs there is widespread variation in their use and a national consensus on this important issue is long overdue.

Dosage finding and outcome in the treatment of schizophrenic inpatients with amisulpride. Results of a drug utilization observation study

“…At the same time it also gives information on the utilization of atypical antipsychotics in general and can serve as an important source of evidence for treatment recommendations and guidelines (Balestrieri et al, 2000;Curran et al, 2002), because clinical studies as well as utilization observations each cover unique treatment aspects. The reported data come from a drug utilization observation study, which are an important addition to data from controlled clinical trials, as they describe drug management under conditions of routine care.…”

“…As a consequence, treatment under conditions of routine care can and often must deviate considerably from guidelines. Studies on the epidemiology of care and prescribing modalities of drugs are therefore important to validate and improve treatment guidelines, to assure treatment quality, target possible problems, and also to understand better the process of prescribing (Curran et al, 2002).…”

Survey of Atypical Antipsychotic Prescribing by Canadian Child Psychiatrists and Developmental Pediatricians for Patients Aged under 18 Years

“…I n the last 2 decades, the treatment of psychosis has been revolutionized by the widespread adoption of ATAs. [1][2][3] These agents, which in Canada presently include risperidone, olanzapine, quetiapine, and clozapine, have fewer propensities to cause extrapyramidal side effects and carry a significantly lower risk of tardive dyskinesia than do typical agents. 4 For adults, monitoring guidelines and established indications for the use of these medications exist, but not for children, with some exceptions.…”