INTRODUCTION
Antipsychotic medications have unique efficacy in the treatment of acute psychosis from any cause and in the management of chronic psychotic disorders such as schizophrenia. As a class, they are also effective in the treatment of acute agitation, bipolar mania, and other psychiatric conditions.Second-generation antipsychotics (SGAs), also known as atypical antipsychotics, generally have lower risk of extrapyramidal symptoms and tardive dyskinesia compared with first-generation antipsychotics (FGAs). First- and second-generation antipsychotic drugs are more comparable in their clinical efficacy, with the exception of clozapine, an SGA with unique efficacy in treatment-resistant schizophrenia. Antipsychotic drugs differ from one another in dosing, route of administration, pharmacokinetics, side effect profile, and cost, factors that influence the selection of an antipsychotic drug for individual patients.
The pharmacology, administration, and comparative side effects of SGAs available in the United States, including clozapine, are discussed here. The pharmacology, administration, and comparative side effects of FGAs are discussed separately, as is the use of antipsychotics in the treatment of schizophrenia, bipolar disorder, and acute agitation. Guidelines for the prescribing of clozapine are also discussed separately.
●(See "Schizophrenia in adults: Maintenance therapy and side effect management".)