A comparative review of new antipsychotics.
OBJECTIVE
To review the preclinical and clinical properties of various established and putative antipsychotic medications, namely clozapine, risperidone, amisulpride, olanzapine, quetiapine, sertindole, and ziprasidone.


METHODS
This paper proposes a decision algorithm for comparing drugs used for psychotic disorders, based on biochemical profile, experimental pharmacology, postiron emission tomography (PET) scan results, and clinical efficacy on positive, negative, anxious, depressive, and cognitive symptoms. This "quotient" aims to compare the different available drugs, regardless of their development and registration status.


RESULTS
Antipsychotic drugs have been classified in many ways, mainly according to their chemical structure, clinical effects, receptor affinity, or side effects. Preclinical data have indicated that these drugs might be effective antipsychotic agents, causing fewer extrapyramidal side effects than most of the previously marketed drugs. However, the biological basis for the putative superiority of these drugs in treating psychosis has yet to be ascertained.


CONCLUSIONS
Although most antipsychotics have been shown to be at least equivalent to haloperidol on positive symptoms, they must be studied further to establish their absolute and relative efficacy on positive symptoms, negative and primary negative symptoms, cognition, psychotic anxiety, psychotic depression, suicidality, and quality of life. These drugs should be valuable in treating schizophrenia, but their merit in the long-term management of patients with schizophrenia still needs to be confirmed.
Blin
O
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Centre de Pharmacologie Clinique et d'Evaluations Thérapeutiques, Hôpital de la Timone, Marseille, France. oblin@ap-hm.fr
D014150:Antipsychotic Agents / Q000145:classification / Q000494:pharmacology / Q000592:standards* / Q000627:therapeutic use; D001526:Behavioral Symptoms / Q000188:drug therapy; D001921:Brain / Q000187:drug effects; D002986:Clinical Trials as Topic; D003657:Decision Making; D004409:Dyskinesia, Drug-Induced / Q000209:etiology; D006801:Humans; D011954:Receptors, Dopamine / Q000187:drug effects; D011985:Receptors, Serotonin / Q000187:drug effects; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D011954:Receptors, Dopamine; D011985:Receptors, Serotonin