THE NEW ANTIPSYCHOTICS, AND THEIR POTENTIAL FOR EARLY INTERVENTION INSCHIZOPHRENIA

Over almost four decades, few fundamentally different antipsychotic dr ugs evolved to challenge classical neuroleptics as the mainstay of the pharmacotherapy of schizophrenia. However, the recent re-emergence of clozapine, together with the emergence of risperidone, portends an in creasing number of new antipsychotics which are now either traversing the stages of regulatory approval or else well-advanced in clinical de velopment. This article first evaluates the significance of clozapine and risperidone; it then reviews some of the new antipsychotics and ho w they might be classified vis-a-vis potential advantages for patients , outlines putative mechanisms and new therapeutic targets, and consid ers whether such agents may act on any disease process inherent to sch izophrenia. One fundamental issue is the extent to which the new antip sychotics might shift materially the risk-benefit balance towards inte rvention, not just at the earliest possible stage following the onset of psychosis but at a yet earlier, 'prodromal' phase of the disorder w here there is a considerably greater likelihood of 'treating' behaviou ral disturbances that prove not to be the harbingers of psychotic illn ess. (C) 1997 Elsevier Science B.V.