CNS Drugs 2009;
نویسندگان
چکیده
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 837 1. Early Stages of Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 839 2. Efficacy of Antipsychotic Drugs in First-Episode Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 839 2.1 Antipsychotic Drug Dosing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 840 2.2 Efficacy of Typical Versus Atypical Antipsychotic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 841 2.3 Comparative Efficacy of Atypical Antipsychotic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 843 2.4 Efficacy of Antipsychotic Drugs for Negative Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 844 2.5 Summary of Efficacy of Antipsychotic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 845 3. Safety of Antipsychotic Drugs in First-Episode Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 846 3.1 Neurological Adverse Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 846 3.1.1 Tardive Dyskinesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 847 3.2 Metabolic Adverse Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 847 3.3 Prolactin Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 848 3.4 Summary of Safety of Antipsychotic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 848 4. Cognitive Function in First-Episode Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 849 4.1 Cognitive Function and Antipsychotic Drug Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 849 5. Brain Structure and Antipsychotic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 850 5.1 Brain Morphology in the Early Stages of Schizophrenia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 850 5.2 Subcortical Effects of Antipsychotic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 851 5.3 Cortical Effects of Antipsychotic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 851 6. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 852 Abstract Increasingly, it is recognized that first-episode schizophrenia represents aIncreasingly, it is recognized that first-episode schizophrenia represents a critical stage of illness during which the effectiveness of therapeutic interventions can affect long-term outcome. In this regard, the advent of clozapine and subsequent atypical antipsychotic drugs held promise for improved outcomes in patients with first-episode schizophrenia, given the expectation of improved therapeutic efficacy and a more benign side effect burden compared with typical antipsychotic drugs. A growing number of large clinical trials have evaluated the merits of atypical antipsychotic drugs in the early stages of psychosis. A number of conclusions can be drawn from studies REVIEW ARTICLE CNS Drugs 2009; 23 (10): 837-855 1172-7047/09/0010-0837/$49.95/0 a 2009 Adis Data Information BV. All rights reserved.
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