The Aims of Antipsychotic Medication
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The aims of therapy with antipsychotic medications include effecti ve relief of symptoms without the induction of adverse effects, improved quality of life and cost effectiveness, and positive long term outcomes. However, currently available anti psychotics do not meet all of these requirements due to a number of well recognised limitations, such as a marked variability of response, induction of a wide range of adverse effects and a lack of subjective tolerability.
A lack of response to antipsychotic medications occurs in up to 30% of patients and poses a particular challenge to clinicians. The reintroduction of clozapine for the treatment of patients with refractory schizophrenia has proven useful in a good number of patients, albeit with some risk of serious agranulocytosis and at a relatively high cost.
Despite the extensive use of anti psychotics over the last 4 decades, little attention has been paid to the systematic evaluation of quality of life in patients with schizophrenia who receive medications, and in clinical trials of new agents. Similarly, there is a dearth of studies that have examined the cost effectiveness and cost utility of anti psychotics in terms of quality of life.
In general, the aim of anti psychotics of alleviating psychotic symptoms without negatively affecting the functional status of patients has not been adequately, nor consistently, achieved with currently available agents. However, with the recent acceleration in the development of new antipsychotics, it is hoped that new drugs will soon be available which will prove to be more effective in treating more symptoms of schizophrenia and will be associated with fewer, or ideally no, adverse effects.
KeywordsSchizophrenia Adis International Limited Clozapine Risperidone Antipsychotic Medication
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- 3.Wyatt RJ. Cost and savings in schizophrenia. Presentation to the Third Workshop on Cost and Assessment in Psychiatry; 1994 Oct 28-30; Venice,ItalyGoogle Scholar
- 6.Cole JO, Klerman GL, Davies JM. Drugs in the treatment of psychosis in controlled studies. In: Solomon P, editor. Psychiatric drugs. New York: Grune and Stratton, 1966: 153–80Google Scholar
- 10.Prien RF, Levine J, Switalsky RN. Discontinuation of chemotherapy for chronic schizophrenics. Hosp Community Psychiatry 1977; 22: 4–9Google Scholar
- 13.Rappaport M, Hopkins KH, Hall K, et al. Are there schizophrenics for whom drugs may be unnecessary or contraindicated? Int Pharmacopsychiatry 1987; 13: 100–11Google Scholar
- 14.May PRA, Goldberg Sc. Prediction of schizophrenic patients’ response to pharmacotherapy. In: Lipton MA, Di Mascio A, Killam KF, editors. Psychopharmacology: a generation of progress. New York: Raven Press, 1978: 1135–9Google Scholar
- 20.Awad AG. There are real risks and benefits with clozapine in schizophrenia. Med North Am 1992; 4: 234–8Google Scholar
- 21.Awad AG. Subjective response to neuroleptics in schizophrenia. Schizophrenia Bull 1993; 19: 609–18Google Scholar
- 26.Awad AG. Quality of life of schizophrenic patients on medications and implications for new drug trials. Hosp Community Psychiatry 1992; 3: 261–5Google Scholar
- 27.Awad AG. Quality of life in medicated schizophrenics: therapeutic and research implications. In: Shriqui C, Nasrallah H, editors. Contemporary issues in the treatment of schizophrenia. Washington: American Psychiatric Association Press, 1995: 883–46Google Scholar
- 28.Voruganti LNP, Heslegrave R, Awad AG. Schizophrenia, antipsychotic therapy and quality of life — validation of a conceptual model. Presentation to 33rd Annual Meeting of the American College of Neuropsychopharmacology; 1994 Dec 12-16Google Scholar
- 29.Schipper H, Clinch J, Powell V. Definition and conceptual issues. In: Spilker B, editor. Quality of life assessments in clinical trials. New York: Raven Press, 1990: 11–24Google Scholar
- 31.Awad AG. Quality of life on neuroleptics - implications for health economics and drug trials in schizophrenia. Presentation to the Third Workshop on Cost and Assessment in Psychiatry; 1994 Oct 28-30; VeniceGoogle Scholar
- 34.Kane JM, Lieberman JA. Maintenance pharmacotherapy in schizophrenia. In: Meltzer H, editor. Psychopharmacology: the third generation of progress. New York: Raven Press, 1987: 1103–9Google Scholar
- 38.Herz MI.Intermittent medication and schizophrenia. In: Kane JM, editor. Drug maintenance strategies in schizophrenia. Washington: American Psychiatric Association, 1984: 58–68Google Scholar
- 40.Gaebal W, Frick U, Kiipcke W, et al. Early neuroleptic intervention in schizophrenia: are prodromal symptoms valid predictors of relapse? Br J Psychiatry 1993; 163 Suppl. 21: 8–21Google Scholar
- 45.Awad AG. Methodological and design issues in clinical trials of new neuroleptics — an overview. Br J Psychiatry 1993; 163 Suppl. 22: 51–7Google Scholar
- 47.Gerlach J. New anti psychotics: classification, efficacy and adverse effects. Schizophr Bull 1991; 17: 298–309Google Scholar