Atypical neuroleptics in the treatment of schizophrenia

In the past few years novel neuroleptics with significant advantages in com parison to classical substances have been progressively introduced. Because of their mechanism of action, these so-called atypical neuroleptics cause fewer, or even no, extrapyramidal side effects. This is why the treatment w ith these substances results in a markedly increased patient compliance. In addition, atypical neuroleptics show an effect on the schizophrenic negati ve syndrome which leads to distinct improvements of quality of life in many chronic patients. They can participate in daily life, become emotionally i nvolved and their cognitive abilities are preserved or even improved. At pr esent the most important disadvantage of these new agents regards - with on e single exception - their availability in tablet form only, i.e. liquid an d injectable forms - not to mention depot-preparations are not yet availabl e. Finally the comparatively high cost of the atypical neuroleptics prohibi ts their wide use, especially in out-patient care. Nevertheless atypical ne uroleptics should be the treatment of first choice, particularly because of the low incidental of short-term as well as long-term side effects such as tardive dyskinesia.