Posted by ed_uk on November 18, 2004, at 7:11:33
In reply to Re: Specificity of Anti-psychotics » ed_uk, posted by alexandra_k on November 17, 2004, at 15:20:20
Hello Alexandra, thank you for answering my post...
Some of the older APs are quite sedating esp. chlorpromazine, methotrimeprazine etc, but some of the older APs are much less sedating eg. trifluoperazine. Similarly, some of the newer APs are usually sedating eg. clozapine and quetiapine, whereas some are much less likely to cause drowsiness eg. amisulpride.There is some evidence that the newer APs are more effective in treating the negative symptoms of schizophrenia. At least the newer drugs are less likely to worsen the negative symptoms than the old ones!!
Unfortunately, all APs can cause withdrawal symptoms, including a severe exacerbation of the underlying psychosis. Clozapine is particularly problematic in this regard- causing severe withdrawal symptoms in many. Many psychiatrists may not be aware of this and are most likely to assume that the patient has relapsed.
I'm certainly not suggesting that benzodiazepines should be used to treat psychosis in place of APs! But in patients who don't respond well to APs, benzos may be a useful way of relieving severe anxiety. Also, benzos do have the advantage of being much less toxic than APs.
I do think APs have a useful role in schizophrenia. But I strongly believe that their efficacy and impact is often profoundly overexagerated.
Regards,
Ed.
poster:ed_uk
thread:416642
URL: http://www.dr-bob.org/babble/20041118/msgs/417338.html