Current problems with the pharmacotherapy of schizophrenia

J. M. Kane, M. F. Piercey, Ranhosky, C. A. Tamminga

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

The clinical management of schizophrenia is hampered by a variety of important limitations of available antipsychotic agents. Current evidence suggests that among recently relapsed hospitalized patients, fewer than 50% achieved a good response to antipsychotic agents. In addition to the heterogeneity in the degree of response, the time course of response to medication varies greatly. Several weeks may pass before a marked reduction in symptoms-if any-becomes apparent. Although the adverse-effect profiles of antipsychotics vary, these agents generally differ little in terms of efficacy. Clozapine, however, has been shown to be superior in patients who have failed to respond adequately to other agents; clozapine and risperidone may be more effective than standard antipsychotics in the management of 'negative' features of schizophrenia (e.g., poverty of speech, avolition, apathy, and anhedonia). Neurologic adverse effects secondary to nigrostriatal dopamine receptor antagonism are an important reason for poor patient compliance with long-term therapy; clozapine appears to have a reduced propensity to produce extrapyramidal dysfunction. Given the fact that only two new antipsychotic compounds have become available in the United States in the past 18 years, the need for new drug development in this area is clearly unmet.

Original languageEnglish (US)
Pages (from-to)S154-S161
JournalClinical neuropharmacology
Volume18
Issue numberSUPPL. 1
DOIs
StatePublished - Jan 1 1995

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Keywords

  • Antipsychotics
  • Antischizophrenics
  • Compliance
  • Efficacy
  • Relapse

ASJC Scopus subject areas

  • Pharmacology
  • Clinical Neurology
  • Pharmacology (medical)

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