Drugs atypical antipsychotic

Head-to-head comparisons of atypical antipsychotic drugs... 

Considerable funds, time and effort have been expended on pharmacoeconomic evaluation of atypical antipsychotic drugs and many journal... 

A search of Medline, EMBASE and PsycLIT was conducted in August 2000, using the following terms Amisulpride, clozapine, olanzapine, risperidone, sertindole, zotepine, ziprasidone, economics, healthcare, costs. All manufacturers of atypical antipsychotic drugs were contacted in April 2000 and asked to supply primary reference data on their product, and all companies had complied with this request by August 2000. A further manual search was conducted of files and journals kept in the National Centre for Information on Psychotropics at the Maudsley Hospital. Reference sections from all retrieved papers were scrutinized for further relevant references. 

The advent of novel atypical antipsychotic drugs has sharpened the debate in the UK about the cost burden of schizophrenia to the National Health Service (NHS) and the relative cost-effectiveness of these drugs. Schizophrenia has a prevalence of about 0.5% and a lifetime risk of 1%. Because the disease affects adolescents and has a lifetime course associated with a high degree of hospital and social... 

Principally because of its efficacy/tolerability ratio, prescriptions for quetiapine are growing faster than for any other atypical antipsychotic drug at present (personal communication, Astra Zeneca). 

Revicki DA (1999). Pharmacoeconomic studies of atypical antipsychotic drugs for the treatment of schizophrenia. Schizophr Res33 (suppL), slOl-9. 

Conventional antipsychotic drugs such as chlorpromazine and haloperidol have long been used in the treatment of acute mania. More recently, atypical antipsychotic drugs including aripiprazole, olanzapine, quetiapine, risperidone, and ziprasi-done have been approved for the treatment of bipolar mania or mixed mood episodes as monotherapy or in combination with mood-stabilizing drugs.25 Aripiprazole and olanzapine are also approved for maintenance therapy. The combination of olanzapine and fluoxetine is approved for treatment of bipolar depression. Quetiapine is approved for treatment of... 

Ananth, J. et al. (2005). Atypical antipsychotic drugs, diabetes and ethnicity. Expert Opin. Drug Saf, 4, 1111-24. 

Introduced in clinical practice in the 1960s, lithium was the first mood stabilizer to be used in China. This was followed by carbamazepine and sodium valproate. For many years, these were the only treatment options available as mood stabilizers. Although lamotrigine was approved for maintenance treatment of bipolar I disorder in 2003 by FDA (Food and Drug Administration) in the USA, this indication has not yet been approved by the Chinese authorities. At present, only one atypical antipsychotic drug, risperidone, has been approved for treating acute mania (February 2005 by SFDA [State Food and Drug Administration]) in China (see Table 6.1). 

Table 12.1 Percentages of prescription of atypical antipsychotic drugs in each country/territory...

Figure 12.1 Cost of atypical antipsychotic drugs (clozapine and risperidone) in each country/territory for patients with schizophrenia...

Clozapine is the prototype of atypical antipsychotic drugs, and it has been used effectively to treat patients with schizophrenia who are unresponsive or intolerant to typical antipsychotics [7]. Clozapine is characterized as atypical by its preferential binding to serotonin (5-HT2) and dopamine D4 receptors (D4) relative to dopamine D2 receptors [8]. A recent body of work also suggests that atypicality may be defined by the rate at which clozapine dissociates from D2 receptors. Specifically, clo-... 

Stockmeier CA, DiCarlo JJ, Zhang Y, Thompson P, Meltzer HY. Characterization of typical and atypical antipsychotic drugs based on in vivo occupancy of sero-tonin2 and dopamine2 receptors. J Pharmacol Exp Ther 1993 266(3) 1374-1384. 

Meltzer HY. Role of serotonin in the action of atypical antipsychotic drugs. Clin Neurosci 1995 3(2) 64—75. 

Kroeze, W. K., Hufeisen, S. J., Popadak, B. A. et al. HI-histamine receptor affinity predicts short-term weight gain for typical and atypical antipsychotic drugs. Neuropsychopharmacology 28 519-526, 2003. 

Current treatment of schizophrenia relies on atypical antipsychotic drugs 876... 

Nevertheless, some atypical antipsychotic drugs, such as clozapine and olanzapine, have been linked to substantial weight gain, hyperlipidemia and type II diabetes, a new range of medically serious side-effects. 

Meltzer, H. Y. What s atypical about atypical antipsychotic drugs Curr. Opin. Pharmacol. 4 53-57, 2004. 

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