New Atypical Drugs Research Articles

Psychotropic medication use for behavioral symptoms of dementia

Behavioral disturbances associated with dementia are common and burdensome. Although no psychotropic medications are currently approved by the US Food and Drug Administration (FDA) to treat such behavioral symptoms, a variety of drug classes are commonly used for these purposes. Atypical antipsychotic medications may be somewhat effective and are generally considered the pharmacologic treatments of choice; however "black box" warnings have recently been added to their labels by the FDA, warning of significantly increased risks of short-term mortality. Older conventional antipsychotic medications may also be somewhat effective but appear to pose risks that can be at least as great as those of the newer atypical drugs. Although antidepressants, benzodiazepines, mood stabilizers, acetylcholinesterase inhibitors, and N-methyl-D-aspartate (NMDA) receptor antagonists may be considered, particularly in patients with specific types of symptomatology, even less is known about their effectiveness and safety. Also, although various psychotropic medications used for behavioral disturbances in dementia patients may be somewhat effective, they have been increasingly associated with important safety risks.

Diabetes Associated with Atypical Antipsychotic Drugs

Several newer atypical antipsychotic drugs appear to be associated with increased risk for development of diabetes. In this partially industry-sponsored analysis of the U.S. Veterans Affairs database, researchers identified nearly 57,000 nondiabetic schizophrenic …

Newer atypical antipsychotic medication in comparison to clozapine: a systematic review of randomized trials

The aim of this study was to evaluate the effectiveness of newer atypical antipsychotic drugs in comparison to clozapine for schizophrenia. Publications in all languages were searched from all relevant databases and all randomized controlled trials comparing clozapine with newer atypical drugs were included. The review and meta-analysis includes eight studies, most of them short in duration. Newer atypical drugs were broadly similar to clozapine when improvement was measured using a psychosis symptom rating scale or a global index. There was a trend for clozapine to be more effective than the comparators for positive symptoms, and less effective for the negative symptoms. The adverse effect profile of clozapine and newer atypical drugs was dissimilar: while clozapine produced more fatigue, hypersalivation, and orthostatic dizziness, new atypical drugs, with the exception of olanzapine, produced more extrapyramidal symptoms. As these results were obtained from few studies and a relatively small amount of patients, the equal effectiveness and tolerability of new atypical drugs in comparison with clozapine is not yet demonstrated. More trials of sufficient power, with longer duration, and measuring clinically important outcomes are urgently needed.

Antipsychotics in clinical practice: guidelines for safe and effective use.

Antipsychotic drugs have made a significant contribution to the treatment of schizophrenia but the older drugs in particular have significant side-effects. The newer atypical drugs are effective for the treatment of both positive and negative symptoms and they also have significantly fewer serious side-effects. However, these drugs are considerably more expensive that the older drugs and this has generated intense debate about their cost effectiveness. There is now good evidence that when all factors are taken into consideration the atypical drugs are both cost effective and improve the quality of life of patients with schizophrenia. Despite the importance of these drugs there is widespread variation in their use and a national consensus on this important issue is long overdue.

The Toxicity of Antidepressants in Overdose: Incidence and Mechanisms

There are wide variations in the incidence of fatal overdoses with different antidepressants. Older tricyclic drugs such as amitriptyline and dothiepin have a higher incidence of fatality than newer atypical drugs like mianserin, whatever the age of the patient. Differences in incidence arise principally from variations in inherent toxicity and only partly from a combination of variable patient compliance and selective prescription. Inherent toxicity is mainly cardiovascular in nature, and those antidepressants with pronounced quinidine-like and atropine-like effects tend to be the most toxic in overdose. Evidence is emerging that some antidepressants, particularly selective inhibitors of 5-HT reuptake and, for different reasons, the new tricyclic lofepramine, may reduce the risk of fatal overdosage.