Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-11T07:23:00.909Z Has data issue: false hasContentIssue false
  • English
  • Français

Second-generation antipsychotics: are their similarities greater than their differences?

Published online by Cambridge University Press:  16 April 2020

W. Wolfgang Fleischhacker
W. Wolfgang Fleischhacker*
Affiliation:
Department of Biological Psychiatry, Innsbruck University Clinics, Innsbruck, Austria
*
*Correspondance. E-mail address: E-mail address:wolfgang.fleischhacker@uibk.ac-at (W.W. Fleischhaker).
Get access

Abstract

The move towards the use of second-generation antipsychotics for the treatment of schizophrenia has provoked much discussion over how to differentiate between the various second-generation agents available on the market. The aim of this review is to provide information that may help clinicians in the decision-making process. The results of comparative studies on general efficacy measures (such as the Positive and Negative Syndrome Scale [PANSS] and the Brief Psychiatric Rating Scale [BPRS]) and comparative studies on cognition do not clearly favour one second-generation agent over another. However, some differences between second-generation agents have become apparent from studies which have examined specific symptoms such as hostility, suicidal ideation and depression/anxiety. There are also differences between second-generation agents with regard to specific aspects of tolerability. For example, in a number of studies olanzapine is associated with fewer extrapyramidal symptoms (EPS) than risperidone, but treatment with risperidone or amisulpride is associated with less weight gain and somnolence. Some studies have investigated the results of switching patients from one antipsychotic agent to another. They have generally reported a successful switch to a second-generation agent.

Overall, there is not enough scientific evidence available to clearly favour one second-generation antipsychotic agent over another in terms of general efficacy or tolerability. Therefore, clinicians must make an individualised treatment decision, and select the most appropriate antipsychotic agent for each patient.

Keywords

Second-generation antipsychoticsTolerabilityEfficacySide effectsSchizophrenia
Type
Review Article
Information
European Psychiatry , Volume 18 , Issue S2: Schizophrenia: Improving the treatment through increased understanding - Mind Matters 4th International Psychiatry Forum , December 2003 , pp. 38s - 45s
Copyright
Copyright © 2003 European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allison, DB, Mentore, JLet al. Antipsychotic-induced weight gain a comprehensive research synthesis. Am J Psychiatry 1999; 156(11): 1686–96.Google ScholarPubMed
Ananth, J, Venkatesh, Ret al. Atypical antipsychotic drug use and diabetes Psychother Psychosom 2002; 71(5): 244–54.CrossRefGoogle ScholarPubMed
Azorin, JM, Spiegel, Ret al. A double-blind comparative study of clozapine and risperidone in the management of severe chronic schizophrenia. Am J Psychiatry 2001: 158(8): 1305–13.CrossRefGoogle ScholarPubMed
Bilder, RM, Goldman, RSet al. Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. Am J Psychiatry 2002; 159(6): 1018–28.CrossRefGoogle ScholarPubMed
Bondolfi, G, Dufour, Het al. Risperidone versus clozapine in treatment-resistant chronic schizophrenia: a randomized double-blind study. The Risperidone Study Group. Am J Psychiatry 1998; 155(4): 499–504.CrossRefGoogle ScholarPubMed
Briken, P, Nika, Eet al. Effect of zotepine, olanzapine and risperidone on hostility in schizophrenic patients. Schizophr Res 2002; 57(2/3): 311–13.CrossRefGoogle ScholarPubMed
Casey, DE, Carson, WHet al. Switching patients to aripiprazole from other antipsychotic agents: a multicenter randomized study. Psychopharmacology 2003; 166(4): 391–9.CrossRefGoogle ScholarPubMed
Conley RR, Mahmoud, R.A randomized double-blind study of risperidone and olanzapine in the treatment of schizophrenia or schizoaffective disorder. Am J Psychiatry 2001; 158(5): 765–74.CrossRefGoogle Scholar
Cunningham, F, Lambert, Bet al. Antipsychotic-induced diabetes in veteran schizophrenic patients. Pharmacoepidemiol Drug Safety 2003; 12(1)- 154–5.Google Scholar
De Nayer, A, Windhager, E, Rmansyah, I, Larmo, I, Lindenbauer, B, Rittmannsberger, Het al. Efficacy and tolerability of quetiapine in patients with schizophrenia switched from other antipsychotics. Int J Psych Clin Practice 2003; 7: 59–66.CrossRefGoogle ScholarPubMed
Fleischhacker, WW.Clozapine: a comparison with other novel antipschotics. J Clin Psychiatry 1999; 60(12): 30–4.Google Scholar
Fuller, MA, Shermock, KMet al. Service use and costs among VA patients with schizophrenia taking risperidone or olanzapine. Psychiatr Serv 2002; 53(7): 855–60.CrossRefGoogle ScholarPubMed
Geddes, J, Freemantle, Net al. Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis. Br Med J 2000; 321(72/73): 1371–6.CrossRefGoogle ScholarPubMed
Gomez, JC, Sacristan, JAet al. The safety of olanzapine compared with other antipsychotic drugs: results of an observational prospective study in patients with schizophrenia (EFESO study). Pharma-coepidemiologic study of olanzapine in schizophrenia. J Clin Psychiatry 2000: 61(5): 335–43.CrossRefGoogle Scholar
Gureje, O, Miles, Wet al. Olanzapine vs risperidone in the management of schizophrenia: a randomized double-blind trial in Australia and New Zealand. Schizophr Res 2003; 61(2/3): 303–14.CrossRefGoogle ScholarPubMed
Harvey, PD, Green, MF, McGurk, SR, Meltzer, HY. Changes in cognitive functioning with risperidone and olanzapine treatment: a large-scale, double-blind, randomized study. Psychopharmacology 2003, 169,404–11.CrossRefGoogle ScholarPubMed
Heinrich, K, Klieser, Eet al. Risperidone versus clozapine in the treatment of schizophrenic patients with acute symptoms: a double blind, randomized trial. Prog Neuro-Psychopharmacol Biol Psychiatry 1994; 18(1): 129–37.CrossRefGoogle ScholarPubMed
Henderson, DC, Nasrallah, RAet al. Switching from clozapine to olanzapine in treatment-refractory schizophrenia: safety, clinical efficacy, and predictors of response. J Clin Psychiatry 1998; 59(11): 585–88.CrossRefGoogle ScholarPubMed
Kasper, S, Jones, Met al. Risperidone olanzapine drug outcomes studies in schizophrenia (RODOS): health economic results of an international naturalistic study. Int Clin Psychopharmacol 2001; 16(4): 189–96.CrossRefGoogle ScholarPubMed
Kim, KS, Pae, CUet al. Effects of olanzapine on prolactin levels of female patients with schizophrenia treated with risperidone. J Clin Psychiatry 2002; 63(5): 408–13.CrossRefGoogle ScholarPubMed
Kinon, BJ, Basson, BRet al. Strategies for switching from conventional antipsychotic drugs or risperidone to olanzapine. J Clin Psychiatry 2000, 61(11): 833–40.CrossRefGoogle ScholarPubMed
Lecompte, D, Cookson, RF. The economic value of atypical antipsychotics: a comparison of risperidone and olanzapine revisited. Int J Psychiatry Clin Practice 1999; 3: 3–9.CrossRefGoogle ScholarPubMed
Leucht, S, Pitschel-Walz, Get al. Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials. Schizophr Res 1999; 35(1): 51–68.CrossRefGoogle Scholar
Leucht, S, Wahlbeck, Ket al. New generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis Lancet 2003; 361(9369): 1581–9.CrossRefGoogle ScholarPubMed
Lindemayer, JP, Czobor, P, Volavka, J, Lieberman, JA, Citrome, L, Sheitman, Bet al. Olanzapine in refractory schizophrenia after failure of typical or atypical antipsychotic treatment: an open-label switch study. J Clin Psychiatry 2002; 63: 931–5.CrossRefGoogle Scholar
Littrell, KH, Johnson, CG, Hilligoss, NM, Peabody, CD, Littrell, SH. Switching clozapine responders to olanzapine. J Clin Psychiatry 2000;61:912–5.CrossRefGoogle ScholarPubMed
Madhusoodanan, S, Suresh, Pet al. Experience with the atypical antipsychotics - risperidone and olanzapine in the elderly. Ann Clin Psychiatry 1999; 11(3): 113–18.CrossRefGoogle ScholarPubMed
Martin, S, Ljo, H, Peukens, J, Thirumalei, S, Giudicelli, A, Fleurot, Oet al. A double-blind, randomised comparative trial of amisulpride versus olanzapine in the treatment of schizophrenia: short-term results at two months. Curr Med Res Opin 2002; 18(6): 355–62.CrossRefGoogle ScholarPubMed
Meltzer, HY, Alphs, Let al. Clozapine treatment for suicidally in schizophrenia: International suicide prevention trial (InterSePT). Arch Gen Psychiatry 2003; 60(1): 82–91.CrossRefGoogle Scholar
Moher, D, Schulz, KFet al. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials Clin Oral Invest 2003; 7(1): 2–7.CrossRefGoogle Scholar
Mullen, J, Jibson, MDet al. A comparison of the relative safety, efficacy, and tolerability of quetiapine and risperidone in outpatients with schizophrenia and other psychotic disorders: the quetiapine experience with safety and tolerability (QUEST) study. Clin Ther 2001; 23(11): 1839–54.CrossRefGoogle ScholarPubMed
National Institute for Excellence (NICE). Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia, NICE, UK 2002; cite website.Google Scholar
Peuskens, J, Bech, P.et al. Amisulpride vs risperidone in the treatment of acute exacerbations of schizophrenia. Amisulpride study group Psychiatry Res 1999, 88(2): 107–17.CrossRefGoogle ScholarPubMed
Peuskens, J, De Hert, Met al. The clinical value of risperidone and olanzapine: a meta-analysis of efficacy and safety. Int J Psychiatry Clin Practice 2001; 5. 179–87.CrossRefGoogle Scholar
Peuskens, J, Moller, HJet al. Amisulpride improves depressive symptoms in acute exacerbations of schizophrenia: comparison with haloperidol and risperidone. Eur Neuropsychopharmacol 2002; 12(4): 305–10.CrossRefGoogle ScholarPubMed
Potkin, SG, Saha, AR, Kujawa, MJ, Carson, WH, Ah, M, Stock, Eet al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder Arch Gen Psychiatry 2003; 60: 681–90CrossRefGoogle ScholarPubMed
Purdon, SE, Jones, BD, Stip, E, Labelle, A, Addington, D, David, SRet al. Neuropsychological change in early phase schizophrenia during 12 months of treatment with olanazpine, risperidone, or haloperidol Arch Gen Psychiatry 2000; 57: 249–58.CrossRefGoogle ScholarPubMed
Rybakowski, JK, Borkowska, A.The effect of treatment with risperidone, olanzapine or phenothiazines on cognitive functions in patients with schizophrenia Int J Psych Clin Pract 2001; 5: 249–56.Google Scholar
Sacristan, JA, Gomez, JCet al. Doses of olanzapine, risperidone, and haloperidol used in clinical practice: results of a prospective pharma-coepidemiologic study. Clin Ther 2000; 22(5): 583–99.CrossRefGoogle ScholarPubMed
Sartonus, N, Fleischhacker, WW, Gjerris, A, Kern, U, Knapp, M, Leonhard, BEet al. The usefulness and use of second generation antipsychotic medications. Curr Opm Psychiatry 2002; 15(1); SI-S51.Google Scholar
Sartorius, N, Fleischhacker, WW, Gjerris, A, Kern, U, Knapp, M, Leonhard, BEet al. The usefulness and use of second generation antipsychotic medications - an update. Curr Opin Psychiatry 2003; 16(1)-S1-S44.Google Scholar
Sechter, D, Peuskens, Jet al. Amisulpride vs risperidone in chrome schizophrenia: results of a 6-month double-blind study. Neuropsy-chopharmacology 2002; 27(6): 1071–81.CrossRefGoogle Scholar
Spohn, HE, Strauss, ME. Relation of neuroleptic and anticholinergic medication to cognitive functions in schizophrenia. J Abnorm Psychol 1989; 98(4): 367–80.CrossRefGoogle Scholar
Tollefson, GD, Birkett, MA. et al. Double-blind comparison of olanzapine versus clozapine in schizophrenic patients clinically eligible for treatment with clozapine. Biol Psychiatry 2001; 49(1): 52–63.CrossRefGoogle ScholarPubMed
Tran, PV, Hamilton, SHet alDouble-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol 1997; 17(5): 407–18.CrossRefGoogle ScholarPubMed
Volavka, J, Czobor, Pet al. Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder. Am J Psychiatry 2002; 159(2): 255–62.CrossRefGoogle ScholarPubMed
Weiden, PJ, Simpson, GMet al. Effectiveness of switching to zipra-sidone for stable but symptomatic outpatients with schizophrenia J Clin Psychiatry 2003; 64(5): 580–8.CrossRefGoogle ScholarPubMed
Wilton, LV, Heeley, ELet al. Comparative study of mortality rates and cardiac dysrhythmias in post-marketing surveillance studies of sertindole and two other atypical antipsychotic drugs, risperidone and olanzapine. J Psychopharmacol 2001; 15(2): 120–6.CrossRefGoogle ScholarPubMed
WPA. WPA Consensus statement on the use and usefulness of second generation antipsychotic medication World Congress of Psychiatry 2002; Yokohama, Japan.Google Scholar
Submit a response

Comments

No Comments have been published for this article.