New antipsychotic medications: More than old wine and new bottles

Four new antipsychotic medications-clozapine, risperidone, olanzapine, and quetiapine-have been introduced in the United States during the past decade . These new medications now account for the majority of antipsychotic presc riptions. The author reviews specific issues related to the use of traditio nal antipsychotic medications and then highlights the emerging clinical res earch data regarding the new medications, which have all been shown to be e fficacious in the treatment of schizophrenia. Clinical research data indica te that they are also more useful for a broader array of symptoms associate d with schizophrenia than traditional compounds. Furthermore, movement diso rder side Effects are substantially decreased-a property that leads to high er acceptability. Surprisingly, there has been little relationship between the pivotal trials designed for FDA approval and current dosing strategies in broader clinical settings. These dosing issues are described. New uses, including treatment of mood disorders and conduct disorder, are also discus sed. These medicines offer substantial hope for improved treatment of schiz ophrenia.