Treatment Overview When Were Antipsychotics First Developed? Typical Antipsychotics
 		Atypical Antipsychotics Clozapine (clorazil) Clozapine v/s Newer Atypical Antipsychotics? Side Effects


Is Clozapine Better than the
Newer Atypical Antipsychotics?


           Overall, clozapine is considered the best of the  atypical drugs because it rarely causes side effects. Risperidone (Risperdal®), olanzapine (Zyprexa®) and quetiapine (Seroquel®)  have some differences in  their effectiveness at treating psychosis. These drugs also  differ in the side effects they produce on patients. Beyond these differences, all atypical antipsychotics have the following common properties:
(1) Ability to block the receptors of both dopamine D2 and serotonin  (that is, decrease the action of  these   two neurotransmitters in the brain)
(2) Lower incidence of  involuntary muscle contractions than the average typical  drug (Stahl 1999, in Perry 2001)

 

 The table below compares clozapine to other atypical drugs (Perry 2002):

Drug

Serotonin-dopamine antagonist

EPSE fewer than haloperidol

Patients rarely  get EPSE

Incidence of tardive dyskinesia less than typicals

Clozapine

Risperidone

Olanzapine

Quetiapine

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Yes/No

Yes/No

Yes

Yes

Yes

Probably




Drug
 Patients rarely get tardive dyskinesia Prolactin increase less than with haloperidol Prolactin rarely increases Negative symptoms treated better than > 15 mg haloperidol

Effective in treatment-refractory populations

Clozapine

Risperidone

Olanzapine

Quetiapine

Yes

No

No

No

Yes

No

Yes

Yes

Yes

No

No

Yes

Yes

Yes

Yes

No

Yes

Maybe

Maybe

Unknown

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