Atypicality of atypical antipsychotics
by
Farah A.
High Point Regional Health Systems, High Point, N.C.,
and the Department of Psychiatry,
Wake Forest University, Winston-Salem, N.C.
Prim Care Companion J Clin Psychiatry. 2005;7(6):268-74.

ABSTRACT

Objective: To review the current definition of atypicality, discuss the unique features of each atypical antipsychotic, and determine whether the available drugs in this class really meet the classical definition of atypicality.Data Sources: A PubMed search was conducted to identify literature on the subject of this review, supported by additional articles based on the author's clinical knowledge and experience.Study Selection and Data Extraction: Relevant references were extracted and summarized in order to meet the objective of the article.Data Synthesis: Atypical antipsychotics are considered a major advance over conventional antipsychotics, primarily because they offer effective treatment alternatives that are relatively free of extrapyramidal symptoms. In fact, the term atypicality was originally used to describe antipsychotic agents with a minimal risk of causing extrapyramidal symptoms. However, over the years the definition has been modified such that there is currently no consensus on a true definition of atypicality for these agents. Each of the atypical antipsychotics (clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole) commercially available in the United States is unique in terms of its pharmacologic profile, differing with respect to receptor-binding affinity, mechanism of action, and adverse events. Of the available atypical antipsychotics, clozapine and quetiapine have shown the lowest propensity to cause extrapyramidal symptoms. Although the risk of extra-pyramidal symptoms is lower with risperidone and olanzapine than with conventional antipsychotics, risk increases with dose escalation. Data for ziprasidone indicate that the risk of extrapyramidal symptoms may be similar to that of risperidone and olanzapine. There is a concern of akathisia with aripiprazole; however, more experience with this agent is needed before definitive conclusions are made.Conclusion: If the definition of "atypical" antipsychotic is considered to be freedom from extrapyramidal symptoms, then, based on a comprehensive review of available data and clinical experience, clozapine and quetiapine appear to be the only true atypicals.

Quetiapine
Olanzapine
Trimipramine
Antipsychotics
Chlorpromazine
The deficit syndrome
Antipsychotics: review
Schizoaffective disorder
Schizophrenia: new drugs
Bipolars and schizophrenics
Atypical antipsychotic agents
Are atypicals antidepressants?
Partial dopamine agonists for psychosis
Big Pharma and drugs for schizophrenics
Atypical antipsychotics for schizophrenia
5-HT2a inverse agonists as antipsychotics
Atypicals versus traditional antipsychotics
Prescribing anti-psychotics to control children

Refs
and further reading

HOME
HedWeb
Nootropics
cocaine.wiki
Future Opioids
BLTC Research
MDMA/Ecstasy
Superhapiness?
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family