Similarities and Differences Among Antipsychotics

Most antipsychotic drugs act equivalently and potently on the symptoms of schizophrenia, withclozapine as the notable exception. Negative symptoms and cognitive deficits are strongly associatedwith poor prognosis; some reports suggest that these symptoms respond better to second- than to first-generationantipsychotics. Although second-generation antipsychotics exert their action through ablockade of dopamine and serotonin receptors (and some have a more complex action), each has adifferent set of pharmacologic characteristics, including side effects. Due to the differences amongantipsychotics available today, optimizing treatment for individual patients requires choosing themost appropriate drug and, if necessary, switching to a different drug if the first proves unsatisfactory.The treating physician must carefully match the diverse needs of schizophrenic patients with the variedcharacteristics of the second-generation antipsychotics.