CMAJ • June 21, 2005; 172 (13). doi:10.1503/cmaj.1041064.
© 2005 CMA Media Inc. or its licensors
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Right arrow Drugs: psychiatry

Review
Synthèse

Modern antipsychotic drugs: a critical overview

David M. Gardner, Ross J. Baldessarini and Paul Waraich

From the Department of Psychiatry and the College of Pharmacy, Dalhousie University, Halifax, NS (Gardner); Harvard Medical School, and the Psychopharmacology Program, McLean Division of Massachusetts General Hospital, Boston, Mass. (Baldessarini); and the Mental Health Evaluation and Community Consultation Unit, Department of Psychiatry, University of British Columbia, Vancouver, BC (Waraich)

Correspondence to: Dr. David M. Gardner, Queen Elizabeth II Health Sciences Centre, Rm. AJLB 7517, 5909 Veterans Memorial Lane, Halifax NS B3H 2E2; david.gardner{at}dal.ca

Abstract

CONVENTIONAL ANTIPSYCHOTIC DRUGS, used for a half century to treat a range of major psychiatric disorders, are being replaced in clinical practice by modern "atypical" antipsychotics, including aripiprazole, clozapine, olanzapine, quetiapine, risperidone and ziprasidone among others. As a class, the newer drugs have been promoted as being broadly clinically superior, but the evidence for this is problematic. In this brief critical overview, we consider the pharmacology, therapeutic effectiveness, tolerability, adverse effects and costs of individual modern agents versus older antipsychotic drugs. Because of typically minor differences between agents in clinical effectiveness and tolerability, and because of growing concerns about potential adverse long-term health consequences of some modern agents, it is reasonable to consider both older and newer drugs for clinical use, and it is important to inform patients of relative benefits, risks and costs of specific choices.




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