Effects of antipsychotics on the clinical and psychosocial behavior of patients with schizophrenia.

With the arrival of atypical antipsychotic drugs, questions have arisen as to their efficacy, compared with classical antipsychotics, and their impact on the clinical and psychosocial behavior of schizophrenic patients. This paper reviews the development of antipsychotic drugs from the prototype chlorpromazine in the 1950s to the atypical antipsychotics--clozapine, risperidone, olanzapinein--in the 1990s. Particular attention is given to the medications' effect on positive and negative symptoms and on patients' quality of life. Experience to date with the atypical antipsychotic drugs is that they are as effective as traditional treatments, with a possibly greater action in treating negative symptoms and with a lower extrapyramidal side effects profile. For comprehensive treatment of schizophrenia, the author advocates a polydimensional approach encompassing psychopharmacology, psychotherapy, psychosocial interventions (particularly with family members), and vocational training.