Are There Any Differences in the Efficacy among Second Generation Antipsychotics in the Treatment of Schizophrenia and Related Disorders?

Motlová, Lucie Bankovská; Španiel, Filip; Höschl, Cyril; Balon, Richard

doi:10.1080/10401230701334606

Cited by 10 publications

(5 citation statements)

References 36 publications

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“…Of two recent reviews, one concluded that it was difficult to distinguish atypical antipsychotic drugs in terms of efficacy134 while the other concluded that there were significant differences in both efficacy and tolerability 135. Nevertheless, amisulpride may offer advantages over other atypical antipsychotic drugs in the treatment of negative and depressive symptoms, and tolerability advantages such as the avoidance of weight gain 136…”

Section: Discussion: Differential Indications For Amisulpride?mentioning

confidence: 99%

Update on the management of symptoms in schizophrenia: focus on amisulpride

Mortimer¹

2009

NDT

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Amisulpride is an atypical antipsychotic drug with a unique receptor pharmacology which is dose dependent. It is a standard treatment in dysthymia as well as in psychosis. Amisulpride is efficacious, effective and well tolerated in positive symptoms of schizophrenia: there is extensive evidence that it treats negative symptoms when given in low doses, although relative lack of EPS and an antidepressant effect may contribute. In first-episode patients amisulpride is an option, although there is little comparative work available. Amisulpride has the best evidence as an effective adjunct to clozapine treatment. Regarding intellectual function, amisulpride appears cognitive sparing but the clinical relevance of this remains obscure. There is evidence that amisulpride can improve social function but again there is little comparative work to demonstrate any particular advantages. Regarding the current conventional versus atypical antipsychotic controversy, amisulpride did better in switching studies and meta-analyses than in the single large pragmatic randomized trial reported to date. It is a versatile drug, and may offer advantages over other atypical antipsychotic drugs in the treatment of negative and depressive symptoms, and tolerability advantages such as the avoidance of weight gain. Essentially it rests with the treating clinician to employ a rational psychopharmacological approach towards the individual patient: there will be few circumstances in which amisulpride will not be a likely contender as a treatment choice.

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Section: Discussion: Differential Indications For Amisulpride?mentioning

confidence: 99%

Update on the management of symptoms in schizophrenia: focus on amisulpride

Mortimer¹

2009

NDT

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“…Collectively, these findings suggest that amisulpride is an atypical antipsychotic drug with a lower risk of weight gain. Both amisulpride and ziprasidone were preferred to olanzapine in patients who had recently experienced weight gain 40,41. This makes sense because second-generation antipsychotics do not appear to differ regarding efficacy, but both amisulpride and ziprasidone have been shown to cause less weight gain than other compounds 38,42,43…”

Section: Amisulpride: Safety and Tolerabilitymentioning

confidence: 99%

Safety and tolerability of antipsychotics: focus on amisulpride

Juruena

Sena²,

Oliveira³

2010

DHPS

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The introduction of the atypical antipsychotic drugs represents an important advance in the treatment of schizophrenia, because the therapeutic efficacy, tolerability, and safety profiles of these agents seem to be superior to that of the classical neuroleptics. As would be predicted from the pharmacologic profile of a pure D2/D3 receptor blocker, amisulpride is an atypical antipsychotic agent, effective for positive and negative symptoms, which can bring about additional improvement in the social functioning and quality of life of patients with schizophrenia. Amisulpride is effective in acute schizophrenia as determined by Clinical Global Impression scores. The major concern regarding the safety of the atypical antipsychotics is related to their propensity to induce weight gain and alter glucose and lipid metabolism. Amisulpride has one of the lowest potentials for weight gain of all the antipsychotic agents, and is associated with clearly lower use of antiparkinsonian medication and with fewer dropouts due to adverse events than conventional antipsychotics. Amisulpride is well tolerated with regard to anxiety and insomnia, and not notably different from placebo. Amisulpride has a pronounced prolactin-elevating effect which appears to be independent of dosage and duration of administration. Hyperprolactinemia rapidly reverses following amisulpride discontinuation. Amisulpride benefits patients with negative symptoms, and is the only antipsychotic to demonstrate efficacy in patients with predominantly negative symptoms. Amisulpride maintains its efficacy when used for medium/long-term treatment, as demonstrated in studies of up to 12 months. In terms of relevance of the effects, superiority is observed for quality of life, social adaptation, and functioning, as measured by the Quality of Life and Functional Status Questionnaire scales. In conclusion, amisulpride is an antipsychotic agent with proven efficacy and good tolerability. Moreover, this drug can help people with schizophrenia to attain social reinsertion.

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“…First-generation (conventional) and second-generation (atypical) antipsychotics are eff ective in treating the positive symptoms associated with these disorders, but effi cacy for negative symptoms and cognitive dysfunction is an unmet need. Considerable accumulated data suggest that antipsychotics diff er more in terms of safety and tolerability than effi cacy [18,25] . Asenapine is an atypical antipsychotic approved in the United States of America for the acute treatment of schizophrenia in adults and for the…”

Section: Introduction ▼mentioning

confidence: 99%