Psychiatric Quarterly

, Volume 73, Issue 4, pp 297–311

Safety and Tolerability: How Do Newer Generation “Atypical” Antipsychotics Compare?

  • Rajiv Tandon

DOI: 10.1023/A:1020464017021

Cite this article as:
Tandon, R. Psychiatr Q (2002) 73: 297. doi:10.1023/A:1020464017021


Previously, clinicians worked with antipsychotic drugs that almost invariably caused extrapyramidal side effects (EPS) at the dose at which they were clinically effective. By definition, all newer generation atypical antipsychotic agents are significantly better than conventional agents with regard to EPS; i.e., they are clinically effective at doses at which they do not cause EPS. This EPS advantage of atypical antipsychotics translates into several important clinical benefits, including better negative symptom efficacy, lesser dysphoria, less impaired cognition, and a lower risk of tardive dyskinesia; in fact, this “EPS advantage” is the principal basis of the many clinical advantages provided by the class of atypical antipsychotics. While all atypical agents share this “EPS advantage,” there are important differences between these agents with regard to the ease and consistency with which this EPS advantage can be realized. Pharmacologically, different atypical antipsychotics differ; these differences translate into differences in their side effect profiles. Five atypical antipsychotics are currently available: clozapine, risperidone, olanzapine, quetiapine, and ziprasidone. Meaningful differences between these agents with regard to weight gain, sedation, anticholinergic side effects, cardiovascular issues, endocrine side effects, hepatic and sexual issues, will be considered and their clinical implications discussed.

antipsychoticsside effectstreatmentschizophreniapharmacology

Copyright information

© Human Sciences Press, Inc. 2002

Authors and Affiliations

  • Rajiv Tandon
    • 1
  1. 1.University of Michigan Medical CenterAnn Arbor