They concluded that the atypical antipsychotics’ apparent advantage in terms of EPSs was not enough to improve their overall tolerability or to warrant recommending them as first-line treatments. To summarize the existing evidence, it is reasonably clear that, atypical antipsychotics are at least, as effective as the conventional antipsychotics in reducing positive symptoms in patients with schizophrenia. Claims that they are superior in reducing Inhibitors,research,lifescience,medical positive symptoms have not yet been proven.21,22 Olanzapine and risperidone appear to be slightly more effective than conventional antipsychotics in reducing negative symptoms, but it is not

clear whether this is due to a direct therapeutic effect or to less frequent EPSs or other secondary causes of negative symptoms.21 Long-term trials of the effectiveness of atypical

antipsychotics in reducing negative symptoms are needed.7 Existing studies have found that atypical antipsychotics cause fewer EPSs than their Inhibitors,research,lifescience,medical conventional counterparts, especially when the conventional comparator is haloperidol. In spite of marketing claims, studies of effects Inhibitors,research,lifescience,medical on cognitive function are wholly inconclusive, as are studies of the effects on mood symptoms. The effects of these drugs on long-term outcome, relapse prevention, social and vocational functioning, suicide prevention, quality of life, and family and caregiver

burden have just begun to be explored. Although first introduced only in the mid-1990s, risperidone, Inhibitors,research,lifescience,medical olanzapine, and quetiapine now account for more than half the new antipsychotic OSI-027 cell line prescriptions in the USA and Canada. The rates of usage vary in Europe, Asia, and South America from as low as 5% to as much as 40%. Patients who had inadequate therapeutic responses to conventional antipsychotics or who suffered problematic side effects were the first to be switched to the atypical antipsychotics. Now, however, many newly diagnosed or first-episode Inhibitors,research,lifescience,medical patients are initially prescribed these newer agents with the hope (not yet backed by evidence) of giving them every early advantage.27 Worldwide, many patients with schizophrenia, continue treatment Rolziracetam with the conventional antipsychotics. Because there are no long-acting atypical preparations yet available, conventional antipsychotics in a long-acting injectable form retain an important role for patients who cannot, adhere to oral regimens. (At the beginning of 2001, a long-acting version of risperidone was in phase 2 trials.) Atypical antipsychotic medications are several times more expensive than conventional antipsychotics in the USA, averaging $5000 or more per patient per year. Thus, these medications have substantial potential for influencing the use of scarce resources.