CONVENTIONAL ANTIPSYCHOTIC MEDICATIONS FOR SCHIZOPHRENIA

This article reviews the existing evidence for the efficacy and effect iveness of conventional antipsychotic medications in the treatment of schizophrenia. Among the issues reviewed are their efficacy for acute symptom episodes and. for long-term maintenance therapy, differential efficacy among medications, the gap between research-based efficacy ra tes;ind effectiveness rates in practice, dosing strategies, and the tr eatment of first-episode cases. Evidence for efficacy is overwhelming for reduction of positive symptoms but quite limited for other outcome s. Effectiveness in practice may be substantially less than efficacy i n clinical trials, perhaps owing to patient heterogeneity, prescribing practices, and noncompliance. First-episode patients should be treate d with antipsychotic medication, but perhaps at lower dosages, with co nsideration of a gradual decrease or discontinuation at 6 months to 1 year.