The aims of therapy with antipsychotic medications include effective r
elief of symptoms without the induction of adverse effects, improved q
uality of life and cost effectiveness, and positive long term outcomes
. However, currently available antipsychotics do not meet all of these
requirements due to a number of well recognised limitations, such as
a marked variability of response, induction of a wide range of adverse
effects and a lack of subjective tolerability. A lack of response to
antipsychotic medications occurs in up to 30% of patients and poses a
particular challenge to clinicians. The reintroduction of clozapine fo
r the treatment of patients with refractory schizophrenia has proven u
seful in a good number of patients, albeit with some risk of serious a
granulocytosis and at a relatively high cost. Despite the extensive us
e of antipsychotics over the last 4 decades, Little attention has been
paid to the systematic evaluation of quality of life in patients with
schizophrenia who receive medications, and in clinical trials of new
agents. Similarly, there is a dearth of studies that have examined the
cost effectiveness and cost utility of antipsychotics in terms of qua
lity of life. In general, the aim of antipsychotics of alleviating psy
chotic symptoms without negatively affecting the functional status of
patients has not been adequately, nor consistently, achieved with curr
ently available agents. However, with the recent acceleration in the d
evelopment of new antipsychotics, it is hoped that new drugs will soon
be available which will prove to be more effective in treating more s
ymptoms of schizophrenia and will be associated with fewer, or ideally
no, adverse effects.