Treatment with atypical antipsychotics: new indications and new populations

Atypical antipsychotics have revolutionized the treatment of schizophrenia, becoming the treatment of choice for patients not only during their first episode, but also throughout their life course. Of note, as of 1999 more th an 70% of prescriptions for these drugs are being prescribed for conditions other than schizophrenia, such as bipolar disorder and geriatric agitation . While there have been very few controlled trials that have established th e efficacy of the atypical antipsychotics for these "off-label" uses, there have been a large number of open trials and case reports. The few controll ed trials suggest that the atypical antipsychotics may be useful for affect ive disorders (both mania and depression), geriatric conditions such as sen ile dementia and aggression, as well as a variety of other disorders. Atypi cal agents may be particularly helpful for elderly, child, or adolescent pa tients who are especially susceptible to the side effects of medications an d whose risk of tardive dyskinesia is high but further controlled studies a re necessary. (C) 2001 EIsevier Science Ltd. All rights reserved.