Efficacy and safety of novel antipsychotics: A critical review

Efficacy and safety of novel antipsychotic (AP) drugs (amisulpride, olanzap ine, quetiapine; ziprasidone and zotepine) have been reviewed. Data on thei r antipsychotic efficacy and side effects profile have been evaluated only on the basis of controlled trials so far published. Overall, all these drug s have shown an antipsychotic efficacy on positive symptoms of schizophreni a similar to that of the conventional AP drugs. On negative symptoms, all n ovel AP drugs, except quetiapine and ziprasidone, demonstrated a better eff icacy than haloperidol. Long-term efficacy of these AP drugs in the mainten ance treatment of schizophrenia needs to be explored by further, better-des igned, epidemiological studies. The safety profile shows that the never AP drugs are generally well-tolerated and induce significantly less acute extr apyramidal side effects in comparison with haloperidol. Some methodological flaws in the experimental design of the clinical trials analysed are discu ssed. Although these novel AP drugs have potential clinical advantages, a n umber of relevant questions still remain to be addressed, in order to estab lish the impact of these drugs in the overall treatment of schizophrenia. C opyright (C) 2000 John Wiley & Sons, Ltd.