Treatment Guidelines from The Medical Letter
Drugs for Psychotic Disorders
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Revised 3/20/13: Table 2 has been revised.

The antipsychotic drugs listed in Table 1 on the next page are more effective for treating the “positive symptoms” of schizophrenia (hallucinations and delusions) than the “negative symptoms” (apathy, social withdrawal, and blunted affect). Some symptoms of schizophrenia and acute psychoses may improve rapidly after treatment with antipsychotic drugs, but chronic schizophrenia improves slowly over many weeks and some patients may continue to improve for months. Most patients with chronic schizophrenia require prolonged maintenance therapy, but the risk of tardive dyskinesia and adverse metabolic effects must be kept in mind.

MECHANISM OF ACTION — All antipsychotic drugs have antagonist effects at dopamine D2 receptors. The first-generation drugs are primarily D2 antagonists; second-generation (“atypical”) antipsychotics interact with other neurotransmitter receptors as well, including ... more      

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