Letters to the Editor Re: From Chlorpromazine to Clozapine—Antipsychotic Ad- verse Effects and the Clini- cian’s Dilemma

Dear Editor: Dr Abidi and Dr Bhaskara have accurately described new concerns arising from the use of atypical antipsychotics (1). The pharmacotherapy of schizophrenia remains an ongoing challenge for researchers and clinicians. The atypicals cause fewer extrapyramidal side effects (EPSEs) and tardive dyskinesia (TD), but there is growing concern regarding their significant long-term adverse metabolic and cardiac effects. These risks may be comparable to the EPSEs and TD associated with typical antypsychotics. Since atypical antipsychotics are all equally effective, the choice of drug for any given patient is still determined by their relative adverse-effect profile. Thus early identification of patients at high risk for obesity, diabetes, and cardiac disease is essential and requires increased monitoring and management (1).