New antipsychotic agents: Emerging clinical profiles

The past 5 years have witnessed an intense period of change in the pharmacotherapy of schizophrenia. Several new antipsychotic agents have become available for clinical use, and more are likely to appear over the next few years. The new agents require that clinicians treating patients with schizophrenia adopt new ways of thinking regarding the pharmacotherapy of this illness. Longer drug trials than have traditionally been used may be required to determine response to the newer agents, and response should be measured across negative symptoms, cognitive symptoms, and broader rehabilitative dimensions. Clozapine has an established role in treatment- resistant schizophrenia. Other new antipsychotics are being used with broader clinical indications. The relative efficacy of these agents, particularly in treatment-refractory patients, remains to be determined. The availability of the newer agents may represent an opportunity to reduce the incidence of tardive dyskinesia and to gain better management of comorbid substance abuse and aggression among schizophrenic patients. Significant cost savings could accrue from more effective disease management.