Switching antipsychotic therapies.
BACKGROUND
Atypical antipsychotics are superior to conventional antipsychotics in improving positive and negative psychotic symptoms. Atypical antipsychotics do not exacerbate mood symptoms, and may improve mood symptoms and cognitive functioning; additionally, they have better adverse effect profiles than conventional antipsychotics.


OBJECTIVE
To review the benefits of switching patients with schizophrenia or schizoaffective disorder from a conventional to an atypical antipsychotic, or from one atypical antipsychotic to another. In spite of the higher acquisition cost of atypical antipsychotics, overall treatment costs may decrease due to lower relapse and hospitalization rates.


METHODS
A MEDLINE search (January 1977-January 1999) was conducted for articles written in English about efficacy, adverse effects, compliance, and pharmacoeconomics for atypical and conventional antipsychotics.


METHODS
Large, multicenter, double-blind, controlled studies were used for efficacy, safety, tolerability, and pharmaco-economic data. Where appropriate, recent review articles were also used.


RESULTS
Atypical antipsychotics are superior to conventional antipsychotics in the treatment of schizophrenia. Atypical and conventional antipsychotics have different adverse effect profiles, costs, and compliance rates.


CONCLUSIONS
Some patients may benefit by switching from a conventional to an atypical antipsychotic, from an atypical to a conventional antipsychotic, or from one atypical antipsychotic to another. Methods of switching antipsychotic therapies include tapering and cross-over strategies.
Masand
P S
PS
Department of Psychiatry, State University of New York Health Science Center at Syracuse, NY 13210, USA.
Berry
S L
SL
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000191:economics / Q000523:psychology
D014150:Antipsychotic Agents