Evaluating antipsychotic medications: predictors of clinical effectiveness. Report of an expert review panel on efficacy and effectiveness.

Over the course of the last decade, atypical antipsychotic medications (olanzapine, quetiapine, and risperidone) have become first-line choices for acute and maintenance treatment for schizophrenia. In numerous cases, these antipsychotics have replaced typical neuroleptics, which are associated with a high incidence of adverse effects, particularly parkinsonism and tardive dyskinesia. Each pharmaceutical company that produces an atypical antipsychotic has supported numerous studies in an attempt to demonstrate the superiority of its agent compared with its competitors. Many of these studies are, unfortunately, too brief in duration, given that schizophrenia and the other psychoses require long-term treatment. Nevertheless, those studies have yielded interesting and evidence-based data. The clinician cannot, however, rely entirely on data from studies. Clinical experience, which allows clinicians to follow patients for prolonged periods of time, is also important in choosing an antipsychotic medication. This article takes the refreshing approach of considering both of these aspects to guide more appropriate prescription of the atypical antipsychotics.