Atypical antipsychotics part I

Pharmacology, pharmacokinetics, and efficacy

John S. Markowitz, Candace Brown, Thea R. Moore

Research output: Contribution to journalReview article

204 Citations (Scopus)

Abstract

OBJECTIVE: To compare the pharmacology, pharmacokinetics, and efficacy of the newer atypical antipsychotics with those of conventional agents and existing atypical agents. DATA SOURCES: Information was retrieved from a MEDLINE English-literature search from July 1986 to June 1998 and by review of references. Indexing terms included neuroleptics, atypical antipsychotics, clozapine, risperidone, olanzapine, sertindole, quetiapine, and ziprasidone. STUDY SELECTION: Comparative studies were selected when possible; placebo- controlled studies were included when data were limited on newer atypical antipsychotics. DATA EXTRACTION: Emphasis was placed on properly designed clinical trials that assessed dosage, expanded efficacy, enhanced adverse effect profile, and cost. DATA SYNTHESIS: Like other atypical antipsychotics, the newer agents have an enhanced 5-hydroxytryptophan/dopaminergic receptors (5-HT2/D2) affinity ratio and undergo extensive biotransformation. Risperidone and olanzapine demonstrate more favorable efficacy/adverse effect ratios than clozapine, sertindole, and conventional antipsychotics in nonrefractory and refractory schizophrenics. Future studies will more clearly define the role of quetiapine and ziprasidone in antipsychotic therapy. CONCLUSIONS: Data from controlled trials on efficacy and extrapyramidal side effects support risperidone or olanzapine as first-line agents for the treatment of schizophrenia. Pharmacologic and pharmacokinetic factors do not distinguish between agents sufficiently for drag selection.

Original languageEnglish (US)
Pages (from-to)73-85
Number of pages13
JournalAnnals of Pharmacotherapy
Volume33
Issue number1
DOIs
StatePublished - Jan 1 1999

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Antipsychotic Agents
olanzapine
Pharmacokinetics
Pharmacology
Risperidone
Clozapine
5-Hydroxytryptophan
Biotransformation
MEDLINE
Schizophrenia
Placebos
Clinical Trials
Costs and Cost Analysis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Atypical antipsychotics part I : Pharmacology, pharmacokinetics, and efficacy. / Markowitz, John S.; Brown, Candace; Moore, Thea R.

In: Annals of Pharmacotherapy, Vol. 33, No. 1, 01.01.1999, p. 73-85.

Research output: Contribution to journalReview article

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