Management of chronic psychotic ambulatory outpatients

The introduction of novel atypical antipsychotic medicines has raised new p ossibilities in the treatment of psychotic patients. In particular, the dis covery of pharmacologic agents that may ameliorate the most stubborn positi ve and also negative symptoms without adding the burden of major side effec ts is revolutionizing treatment expectations. However, it is also becoming abundantly clear that successful treatment requires more than just the admi nistration of a medicine. Treatment must also address the inner experiences of the patient, as well as the social and psychological handicaps that are associated with the illness. Some of the relatively neglected complication s of using typical antipsychotic medicines include hyperprolactinemia and a ntipsychotics that may require concomitant treatment with anticholinergic a gents, which themselves have an array of side effects. This article present s a detailed method for deciding when and how to use the new medications ef fectively and how to manage the transition from one medicine to another.