CLOZAPINE AND RISPERIDONE - REFINING AND EXTENDING THEIR USE

The recent advent of atypical antipsychotic medications has provided n ew clinical options and set higher expectations for the treatment of s chizophrenia and other psychoses. Two such drugs, clozapine and risper idone, are currently employed in the United States. Researchers contin ue to fine-tune treatment with these agents and to seek possible new u ses for them. For clozapine, refinements in use (optimal duration of t rial, optimal dose, use of drug plasma level to optimize efficacy) are described, along with side effects and the specificity (or lack there of) of the drug's action upon primary negative symptoms. Also discusse d is use of clozapine in new subgroups of patients-for example, those with first-episode schizophrenia, polydipsia syndrome, or a dual diagn osis. For risperidone, use in patients with first-episode schizophreni a, affective disorders, autism, and other disorders is described. Cost -benefit considerations are presented for both drugs. The psychosocial needs of patients taking these medications and the potential for syne rgy between novel antipsychotics and modern psychosocial therapies are also discussed.