drug therapy

• P: support for the effectiveness of antipsychotics comes from studies that have compared relapse rates for antipsychotics and placebos

  E: Leucht carried out a meta analysis of 65 studies. some patients were taken off their antipsychotic medication and given a placebo instead. the remaining patients remained on their regular antipsychotic. 64% of patients who had been given the placebo had relapsed, compared to 27% of those who stayed on the antipsychotic.
• link for placebos

  L: this study clearly demonstrates the superiority of antipsychotic drugs compared to placebo in preventing relapse, although their use must be weighed against their side effects
• P:typical antipsychotic drugs can sometimes produce movement problems for the patient. these are called extrapyramidal effects because antipsychotic drugs appear to impact on the extrapyramidal area of the brain, which helps control motor activity

  E: the most common are parkinsonian and related symptoms, so called because they resemble the features of the neurological disorder parkinson's disease. more than half of the patients taking typical antipsychotics experience these symptoms.
• link for extrapyramidal side effects

  L: these side effects can be so distressing for the patient that other drugs have to be given to control them, or the patient may stop taking their antipsychotic medication completely
• P: atypical antipsychotics are claimed to have a number of advantages when compared to typical antipsychotics. a key advantage of atypical antipsychotics is that patients experience fewer side effects

  E: atypical antipsychotics, particularly newly developed drugs, such as olanzapine and quetiapine, are less likely to produce the extrapyramidal effects commonly found with typical antipsychotics

  L: as a result, patients are more likely to continue with their medication, which in turn means they are more likely to see a reduction in their symptoms