Conventional antipsychotic medications for schizophrenia.
This article reviews the existing evidence for the efficacy and effectiveness of conventional antipsychotic medications in the treatment of schizophrenia. Among the issues reviewed are their efficacy for acute symptom episodes and for long-term maintenance therapy, differential efficacy among medications, the gap between research-based efficacy rates and effectiveness rates in practice, dosing strategies, and the treatment of first-episode cases. Evidence for efficacy is overwhelming for reduction of positive symptoms but quite limited for other outcomes. Effectiveness in practice may be substantially less than efficacy in clinical trials, perhaps owing to patient heterogeneity, prescribing practices, and noncompliance. First-episode patients should be treated with antipsychotic medication, but perhaps at lower dosages, with consideration of a gradual decrease or discontinuation at 6 months to 1 year.
Dixon
L B
LB
Dept. of Psychiatry, University of Maryland School of Medicine, Baltimore 21201, USA.
Lehman
A F
AF
Levine
J
J
D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008134:Long-Term Care; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents