Typical and Atypical Antipsychotics – The Misleading Dichotomy

@article{FischerBarnicol2008TypicalAA,
  title={Typical and Atypical Antipsychotics – The Misleading Dichotomy},
  author={David Fischer-Barnicol and Stefan Lanquillon and Ekkehard Haen and Peter Z{\"o}fel and Horst Josef Koch and Matthias Dose and Helmfried E. Klein},
  journal={Neuropsychobiology},
  year={2008},
  volume={57},
  pages={80 - 87}
}
Objectives: (1) To investigate the risk of extrapyramidal motor side effects (EPS) associated with the prescription of different antipsychotics under naturalistic treatment conditions; (2) to test the rationale of the terms ‘typical’ and ‘atypical’ based on EPS rates. Design: Cross-sectional study in the federal state of Bavaria. Setting: 20 psychiatric hospitals in Bavaria. Participants: 6,061 inpatients, aged 18–65 years, with psychotic disorders. Main Outcome Measures: Co-medication with the… Expand
Antipsychotic treatment of schizophrenia: an update.
The primary objectives in the treatment of schizophrenia are to reduce the frequency and severity of psychotic exacerbation, ameliorate a broad range of symptoms, and improve functional capacity andExpand
Meet the relatives: a reintroduction to the clinical pharmacology of ‘typical’ antipsychotics (Part 1)
A number of pragmatic trials have cast doubt on the concept of ‘atypicality’ in relation to anti-psychotic drugs, and some commentators have argued that the dichotomy between ‘typical’Expand
Optimization of psychopharmacotherapy for schizophrenia in a male, locked, non-acute unit serving for persistently ill patients over one year
TLDR
Optimization of psychopharmacotherapy is still possible for difficult-to-treat patients and, while augmentation of an antipsychotic with mood stabilizers is frequently needed, antipsychotics with polypharmacy should be exceptional. Expand
Atypical Antipsychotic Drugs in the Treatment of Parkinson’s Disease
TLDR
Double blind, placebo controlled trials (DBPCT) have shown that clozapine is effective at controlling the psychotic symptoms at doses far below those used in schizophrenia, without worsening motor function, even improving tremor, while DBPCT have demonstrated that olanzapine worsens motor function without improving psychosis. Expand
From receptor pharmacology to improved outcomes: individualising the selection, dosing, and switching of antipsychotics
TLDR
To optimize outcomes, antipsychotic treatment should be pharmacologically informed and measurement based, combining both acute and long-term management goals and balancing efficacy and adverse effect considerations. Expand
Second-Generation Antipsychotics and Extrapyramidal Adverse Effects
TLDR
The incidence and severity of extrapyramidal syndrome differ amongst these antipsychotics, but the fact is that these drugs have not lived up to the expectation regarding their tolerability. Expand
Atypical antipsychotics for psychosis in adolescents.
TLDR
This systematic review collates and critiques evidence obtained on the use of various atypical antipsychotic medications for adolescents with psychosis, finding no data on service utilisation, economic outcomes, behaviour or cognitive response. Expand
Some novelties and recommendations by swithing antipsychotics
TLDR
The basic rules and ways of replacing antipsychotic drugs in different clinical situations are specified, and alerts, recommendations and suggestions when changing antipsychotics are summarized. Expand
Schizophrenia: 1979-2009
Background: As more becomes known about the complex causation of schizophrenia, the variability of treatment response, and the effectiveness of preventive measures, treatments are likely to change.Expand
Volumetric Changes in the Basal Ganglia After Antipsychotic Monotherapy: A Systematic Review
TLDR
Brain structural support is added to the notion that antipsychotics should no longer be classified as either FGAs or SGAs, as both volumetric increases and decreases in the BG have been associated with SGA monotherapy. Expand
...
1
2
3
4
...

References

SHOWING 1-10 OF 52 REFERENCES
Effects of Newer Antipsychotics on Extrapyramidal Function
TLDR
No atypical antipsychotic is clearly effective for motor abnormalities in Huntington’s disease or Tourette's syndrome, and the effect of these drugs on other neurological disorders have been well evaluated in only small numbers of patients. Expand
Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis
TLDR
There is no clear evidence that atypical antipsychotics are more effective or are better tolerated than conventional antipsychotic drugs. Expand
The Prevalence of Acute Extrapyramidal Signs and Symptoms in Patients Treated With Clozapine, Risperidone, and Conventional Antipsychotics
Background Acute extrapyramidal side effects (EPS) are a common phenomenon of treatment with conventional antipsychotics. Previous studies found that clozapine has little propensity to cause EPS,Expand
Extrapyramidal syndromes in neuroleptic-treated patients: prevalence, risk factors, and association with tardive dyskinesia.
TLDR
It is suggested that the association between EPS and TD may be limited to specific subtypes of TD, and peripheral TD showed a higher association with parkinsonism and with akathisia, suggesting that these symptoms may share a common pathophysiology. Expand
New generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis
TLDR
New generation drugs were moderately more efficacious than low-potency antipsychotics, largely irrespective of the comparator doses used, and potential advantages in efficacy of the new generation drugs should be a factor in clinical treatment decisions to use these rather than conventional drugs. Expand
Extrapyramidal side effects, tardive dyskinesia, and the concept of atypicality.
  • W. Glazer
  • Medicine, Psychology
  • The Journal of clinical psychiatry
  • 2000
TLDR
The mechanisms of neuroleptic-induced EPS and tardive dyskinesia are reviewed and the relationship between these movement disorders and atypical antipsychotic agents is discussed. Expand
Neuroleptic-induced extrapyramidal symptoms are accompanied by cognitive dysfunction in schizophrenia.
TLDR
It is concluded that high EPS patients suffer from cognitive disturbances which are assumed to possess high relevance for both psycho-social and medical treatment. Expand
Extrapyramidal side effects are unacceptable
  • J. Kane
  • Medicine
  • European Neuropsychopharmacology
  • 2001
TLDR
Clinical trials with the new generation of atypical antipsychotics suggest that they are associated with a reduction in both early- and late-occurring EPS, and reduce the need for antiparkinsonian medication in comparison with haloperidol. Expand
Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials
TLDR
All of the 4 new drugs are more effective than placebo, but the magnitude of the effect is only moderate, and all new antipsychotics are associated with less frequent use of antiparkinson medication than haloperidol. Expand
Risperidone versus typical antipsychotic medication for schizophrenia.
TLDR
Risperidone appears to have little or no additional effect on the positive and negative symptoms of schizophrenia but did have less tendency to cause movement disorders, largely in comparison with haloperidol. Expand
...
1
2
3
4
5
...