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PRAKASH S. MASAND, M.D., is Consulting Professor of Psychiatry and Behavioral Medicine, Duke University Medical Center, Box 3391 Med Ctr, Durham, NC 27710 (prakash.masand{at}duke.edu).

Purpose. Pharmacology of atypical antipsychotics and the clinical implications are reviewed. Summary. Psychiatric disorders, such as schizophrenia and bipolar disorder, are often associated with poor outcomes. Atypical antipsychotics have become the standard of care for these disorders, and multiple agents have demonstrated efficacy for both acute and maintenance therapy. As a result of their differential pharmacologic properties, atypical antipsychotics have diverse clinical profiles, resulting in different liabilities for specific adverse events. These effects can, in turn, have an adverse impact on patient functionality, adherence to therapy, and overall health. Conclusion. Atypical antipsychotics have distinct pharmacological profiles which result in clinically meaningful differences in adverse effects. Clinicians should have a wide choice of agents available with which to optimize outcomes in the majority of patients with psychiatric disorders. Index terms: Antipsychotic agents; Compliance; Drugs; Mechanism of action; Mental disorders; Patients; Toxicity