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Titolo:
Conventional versus novel antipsychotics: changing concepts and clinical implications
Autore:
Remington, G; Chong, SA;
Indirizzi:
Clarke Inst Psychiat, Schizophrenia Div, Toronto, ON M5T 1R8, Canada Clarke Inst Psychiat Toronto ON Canada M5T 1R8 oronto, ON M5T 1R8, Canada Univ Toronto, Dept Psychiat, Toronto, ON M5S 1A1, Canada Univ Toronto Toronto ON Canada M5S 1A1 chiat, Toronto, ON M5S 1A1, Canada Inst Mental Hlth, Singapore, Singapore Inst Mental Hlth Singapore Singapore Mental Hlth, Singapore, Singapore Woodbridge Hosp, Singapore, Singapore Woodbridge Hosp Singapore Singapore odbridge Hosp, Singapore, Singapore
Titolo Testata:
JOURNAL OF PSYCHIATRY & NEUROSCIENCE
fascicolo: 5, volume: 24, anno: 1999,
pagine: 431 - 441
SICI:
1180-4882(199911)24:5<431:CVNACC>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUROLEPTIC-RESISTANT SCHIZOPHRENIA; D2-DOPAMINE RECEPTOR OCCUPANCY; CAUDATE NUCLEI VOLUMES; DOUBLE-BLIND; REFRACTORY SCHIZOPHRENIA; COST-EFFECTIVENESS; SCHIZOAFFECTIVE DISORDER; TYPICAL ANTIPSYCHOTICS; RISPERIDONE RESPONSE; CLOZAPINE TREATMENT;
Keywords:
antipsychotic agents; classification; clozapine; drug therapy; receptors, drug; risperidone; schizophrenia;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Citazioni:
101
Recensione:
Indirizzi per estratti:
Indirizzo: Remington, G Clarke Inst Psychiat, Schizophrenia Div, 250 Coll St, Toronto, ON M5T 1R8,Canada Clarke Inst Psychiat 250 Coll St Toronto ON Canada M5T 1R8 da
Citazione:
G. Remington e S.A. Chong, "Conventional versus novel antipsychotics: changing concepts and clinical implications", J PSYCH NEU, 24(5), 1999, pp. 431-441

Abstract

Novel antipsychotics represent a significant advance in the treatment of schizophrenia after many years of few developments. The conventional antipsychotics are potent D-2 antagonists, but fail to achieve a response in about30% of cases. They are also associated with a high rate of extrapyramidal side effects. The greater and broader spectrum of efficacy combined with the reduced short- and long-term side effects of the new drugs such as quetiapine, risperidone, olanzapine and ziprasidone, contribute to a fresh optimism for the pharmacotherapy of schizophrenia. These novel agents are now driving further advances in schizophrenia research through a growing understanding of their pharmacological and clinical profiles. Clozapine, the first novel antipsychotic, has relatively low activity at D-2 receptors, a high affinity for D-4 receptors and a greater 5-HT2 (serotonin) than D-2 antagonism. Hence, clozapine and other novel antipsychotics can be classified as such by this latter characteristic. However, some of these drugs have D-2 occupancy greater than 60% (the clinical response threshold), while others havea lower D-2 occupancy. The novel antipsychotics according have also been classified according to their activity on different neurotransmitter systems. While more effective, novel antipsychotics are not a panacea; they have limitations and side effects. In clinical practice, the American PsychiatricAssociation recommends either a conventional or novel antipsychotic for initial treatment of schizophrenia, whereas Canadian guidelines recommend navel agents. These agents should also be considered for treatment of refractory schizophrenia. Patients whose schizophrenia does not respond to one of these agents may respond to another. Future research should involve longer clinical trials, given the long periods needed to establish efficacy, and should address many remaining questions about the novel agents.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 16:35:28