Are older antipsychotic drugs obsolete?

doi:10.1136/bmj.332.7554.1346

BMJ 2006;332:1346-1347 (10 June), doi:10.1136/bmj.332.7554.1346

Editorial

Are older antipsychotic drugs obsolete?

The first 150 words of the full text of this article appear below.

Antipsychotic drugs have been essential in treating schizophreniasince chlorpromazine was introduced in the mid 1950s. By 1980over 20 other antipsychotic medications were available, andall of them are now sold as generics. Ever since clozapine wasshown in the late 1980s to be more effective for treatment resistantpatients with schizophrenia than the older antipsychotic agents,¹numerous new antipsychotic drugs have been synthesised and released,with claims of greater efficacy and better tolerability thanthe older generic agents. Are these claims true, and how shouldclinicians go about choosing the appropriate drug for theirpatients with schizophrenia?

Several authoritative and widely adopted treatment guidelinesfor the use of antipsychotics, such as the TIMA algorithm (TexasImplementation of Medication Algorithms), recommend only thenewer antipsychotic drugs as first and second line treatments,reinforcing the perception that the older drugs are therapeuticallyinferior. These new antipsychotics are often referred . . . [Full text of this article]

Rohan Ganguli, professor of psychiatry, pathology, and health and community systems

Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
(gangulir@upmc.edu)

Martin Strassnig, resident in psychiatry

Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Psychological and social interventions for schizophrenia: David Kingdon
BMJ 2006 333: 212-213. [Extract] [Full Text] [PDF]

New antipsychotic agents are much awaited: Arnob Chakraborti
BMJ 2006 332: 1511. [Extract] [Full Text]

This article has been cited by other articles:

Rosenheck, R. A., Sernyak, M. J. (2009). Developing A Policy For Second-Generation Antipsychotic Drugs. Health Aff (Millwood) 28: w782-w793 [Abstract] [Full text]
Rosenheck, R. A., Leslie, D. L., Doshi, J. A. (2008). Second-Generation Antipsychotics: Cost-Effectiveness, Policy Options, and Political Decision Making. Psychiatr. Serv. 59: 515-520 [Abstract] [Full text]
Kingdon, D. (2006). Psychological and social interventions for schizophrenia. BMJ 333: 212-213 [Full text]
Chakraborti, A. (2006). New antipsychotic agents are much awaited.. BMJ 332: 1511-1511 [Full text]

Rapid Responses:

Read all Rapid Responses

Truly novel agents are much awaited: arnob chakraborti
bmj.com, 10 Jun 2006 [Full text]
Don't forget the depots: James Rucker
bmj.com, 10 Jun 2006 [Full text]
Antipsychotics should be drugs of last resort: Bruce G Charlton
bmj.com, 11 Jun 2006 [Full text]
Typical antipsychotics are not obsolete, but a shotgun approach to treatment of psychosis should be.: Gabriel A de Erausquin, et al.
bmj.com, 16 Jun 2006 [Full text]
Older generation antipsychotic medications are still useful in developing countries: AMIN ALI MUHAMMAD GADIT
bmj.com, 16 Jun 2006 [Full text]
Survey Your Patient's Preference Between Older Antipsychotics and the Newer Ones: Babatunde Adetunji, MD, et al.
bmj.com, 17 Jun 2006 [Full text]
All antipsychotics are not equal: Anju Kuruvilla, et al.
bmj.com, 26 Jun 2006 [Full text]
pregnancy and schizophrenia: Bharathi Balasundaram
bmj.com, 17 Nov 2006 [Full text]