Has Research Informed Us on the Practical Drug Treatment of Schizophrenia?

We do not know the indication (which patient for which drug) for one antipsychotic versus another or even that one may be uniquely better for an individual patient. We have some information on overall efficacy and safety, which is a different question. Some who believed secondgeneration antipsychotics (SGAs) as a group were more efficacious than first-generation antipsychotic (FGA) drugs were surprised when Clinical Antipsychotic Trials in Intervention Effectiveness and Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study found most were not. But this was not surprising. The results of these studies are generally consistent with both the registrational and postmarketing studies, which have failed to demonstrate superiority for most SGAs, but agree that a few, such as clozapine and perhaps olanzapine, are more efficacious.