Antipsychotics - The future of schizophrenia treatment

Schizophrenia is a debilitating mental disorder affecting up to five in eve ry thousand people. Although specialist psychiatrists are initially respons ible for treating patients suffering from acute schizophrenia, the current structure of mental healthcare in the UK puts the onus for the delivery of maintenance therapy of discharged patients on to the general practitioner. It is crucial, therefore, that the general practitioner is aware of all ava ilable therapies for the effective, long-term, community-based treatment of patients with schizophrenia. The so-called typical antipsychotics effectiv ely treat the positive but not the negative symptoms of schizophrenia, and up to 40% of patients are nonresponders. These antipsychotics, however, are associated with high levels of extrapyramidal side-effects (EPS), which ar e the main cause of patient non-compliance and their subsequent relapse and hospital readmission. Clozapine, the first atypical antipsychotic, may cau se severe agranulocytosis and patients must undergo regular haematological monitoring, which is both costly and a factor unlikely to foster patient co mpliance. in contrast, newly developed atypical antipsychotics, such as ola nzapine and quetiapine are Mot only efficacious in treating the symptoms of schizophrenia, but also give rise to fewer EPS and are generally better to lerated than clozapine. In particular olanzapine and quetiapine are Mot ass ociated with severe agranulocytosis. Atypical antipsychotics, therefore, ha ve the potential to enhance patient compliance and thus ease the general pr actitioner 's problems of providing long-term and effective treatment for p atients with schizophrenia.