All Antipsychotics Are Equal, but Some Are More Equal Than Others

One of the "atypical" features of second-generation antipsychotics(SGAs) that was quickly appreciated by cliniciansand patients shortly after their introduction was that thesemedications were shown to elicit fewer extrapyramidal sideeffects than the first-generation antipsychotics (FGAs). Earlyhead-to-head comparisons of some first-line SGAs with FGAsin patients with schizophrenia also demonstrated better efficacyin terms of overall symptom reduction in studies comparingrisperidone and olanzapine with haloperidol. However, laterstudies failed to demonstrate the superiority of SGAs overFGAs in effectiveness or safety.