Antipsychotic drug treatment: recent advances

Most publications over the past year that are relevant to the topic of anti psychotic drug treatment were concerned with the newer, atypical antipsycho tic drugs, and the present review reflects this emphasis. Accordingly, the latest data on safety and efficacy are discussed for clozapine, risperidone , olanzapine, amisulpride, quetiapine and zotepine. The effects of the new antipsychotics on neurocognition have been a topic of interest for several years, but it has been difficult to draw firm conclusions from the diverse studies. Several useful reviews are now available, along with important and well controlled new studies. As discussed here, these advance our understa nding in this area and support the opinion that the new antipsychotics have individual advantages over conventional drugs. Positron emission tomograph y and single-photon emission tomography ligand-binding studies of these dru gs are also described, because they provide useful information linking dose , D-2-receptor occupancy and clinical response. A second emphasis of the re view concerns the practicalities of treatment with both conventional and th e newer antipsychotics. The latest information regarding the effects of abr upt discontinuation of antipsychotic medication and the treatment of refrac tory schizophrenia is appraised. Finally, the vexing question of how prolon ged duration of untreated psychosis might adversely affect prognosis is con sidered in the light of several new papers, Curr Opin Psychiatry 14:25-37. (C) 2001 Lippincott Williams & Wilkins.