RECENT DEVELOPMENTS IN THE MANAGEMENT OF PSYCHOSIS

Antipsychotic drugs are effective in psychoses, whatever the aetiology of the disorder. The positive symptoms tend to respond more readily T he need for developing new drugs arises from the refractoriness of the negative symptoms, the 10-25% of the patients that are treatment-resi stant and the problems of short-, and long-term extrapyramidal side ef fects. Thus far, five drugs differing from the classical antipsychotic s have been licensed for use: clozapine, olanzepine, risperidone, sert indole and sulpiride, and in at least some European countries quetiapi ne is now in the final phase of clinical research. This review starts with a brief introduction to symptomatology, is limited to the registe red drugs and addresses differences with the classical drugs in pharma cology, pharmacokinetics, clinical aspects and side-effects. Clozapine , risperidone and sulpiride can be considered for clinical use in refr actory patients, and these three together with olanzapine and sertindo le are candidates when extrapyramidal side-effects cause a clinical pr oblem.