THE AIMS OF ANTIPSYCHOTIC MEDICATION - WHAT ARE THEY AND ARE THEY BEING ACHIEVED

The aims of therapy with antipsychotic medications include effective relief of symptoms without the induction of adverse effects, improved quality of life and cost effectiveness, and positive long term outcomes. However, currently available antipsychotics do not meet all of these requirements due to a number of well recognised limitations, such as a marked variability of response, induction of a wide range of adverse effects and a lack of subjective tolerability. A lack of response to antipsychotic medications occurs in up to 30% of patients and poses a particular challenge to clinicians. The reintroduction of clozapine for the treatment of patients with refractory schizophrenia has proven useful in a good number of patients, albeit with some risk of serious agranulocytosis and at a relatively high cost. Despite the extensive use of antipsychotics over the last 4 decades, Little attention has been paid to the systematic evaluation of quality of life in patients with schizophrenia who receive medications, and in clinical trials of new agents. Similarly, there is a dearth of studies that have examined the cost effectiveness and cost utility of antipsychotics in terms of quality of life. In general, the aim of antipsychotics of alleviating psychotic symptoms without negatively affecting the functional status of patients has not been adequately, nor consistently, achieved with currently available agents. However, with the recent acceleration in the development of new antipsychotics, it is hoped that new drugs will soon be available which will prove to be more effective in treating more symptoms of schizophrenia and will be associated with fewer, or ideally no, adverse effects.