CONTEXT Atypical antipsychotic medications are widely used to treat delusions, aggression, and agitation in people with Alzheimer disease and other dementia; however, concerns have arisen about the increased risk for cerebrovascular adverse events, rapid cognitive decline, and mortality with their use. OBJECTIVE To assess the evidence for increased mortality from atypical antipsychotic drug t...

Antipsychotic medications are disproportionately used in elderly populations and have been prescribed to over a quarter of US Medicare beneficiaries in nursing homes. Reasons for their use include dementia, delirium, psychosis, agitation and affective disorders, but much use is outside approved indications. In addition, there have been rapid shifts away from first-generation conventional agents...

Clinical studies indicate that clozapine and olanzapine carry a high risk of treatment-related metabolic dysfunction—including weight gain, hyperlipidemia, and glucose intolerance—but certain patients with high metabolic liabilities who take atypical antipsychotics do not necessarily develop these adverse effects. Though the underlying mechanism for atypical antipsychotic-related weight gain is...

OBJECTIVE Tardive dyskinesia (TD), the principal adverse effect of long-term conventional antipsychotic treatment, can be debilitating and, in many cases, persistent. We sought to explore the incidence and management of TD in the era of atypical antipsychotics because it remains an important iatrogenic adverse effect. METHODS We conducted a review of TD incidence and management literature fro...

OBJECTIVE This study assessed the current state of antipsychotic prescription practices regarding race among veterans receiving care through the Department of Veterans Affairs. METHOD The authors examined pharmacy records over a 12-month period for all veterans with schizophrenia and antipsychotic prescriptions in fiscal year 1999. They used logistic regression analysis to assess the effect o...

BACKGROUND Several clinical practice guidelines suggest using atypical over typical antipsychotics in patients diagnosed with schizophrenia. Nevertheless, cost-containment policy urged restricting usage of atypical antipsychotics and switching from atypical to typical antipsychotics. OBJECTIVE This study aimed to evaluate clinical and economic impacts of switching from atypical to typical ant...

BACKGROUND The extent to which atypical antipsychotics have a lower incidence of extrapyramidal symptoms than typical antipsychotics has not been well-evaluated in community practice. AIMS To examine the effects of switching antipsychotics on antiparkinsonian medication use among individuals with schizophrenia in UK general practices. METHOD We included those switched from typical to atypic...

Participants: Study participants consisted of patients in the United States aged 60 and receiving antipsychotic monotherapy. The following cohorts were studied: an elderly reference population (no antipsychotics: n 1,836,799), those receiving haloperidol (n 6481) or thioridazine (n 1658); all patients receiving any conventional antipsychotic monotherapy (n 11,546), clozapine (n 117), olanzapine...

Diabetes and atypical antipsychotic agents John Newcomer (St. Louis, MO) discussed changes in adiposity and insulin sensitivity with the atypical antipsychotic agents ziprasidone, risperidone, aripiprazole, quetiapine, clozapine, and olanzapine, addressing the diabetes risk seen during treatment. Among persons with schizophrenia, approximately half are obese, half to three-quarters smoke, 10– 1...

The pharmacologic management of schizophrenia has dramatically improved over the past 50 years. While the first-generation, or conventional, antipsychotic medications were found to be helpful in reducing the positive symptoms of the disorder, they had little effect on negative and cognitive symptoms. Additionally, the first-generation agents were associated with the troubling neurologic side ef...