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A Review of Pharmacologic Strategies for Switching to Atypical Antipsychotics

Auteur(s) :

Prakash S. Masand

Résumé :

Background: In daily clinical practice, frequent switching of antipsychotic medications is wide- spread. There are various reasons for switching, including a partial or complete lack of efficacy, adverse side effects, and partial or noncompliance with medication. Patients switched from conven- tional drugs to oral atypical antipsychotic drugs have been shown to benefit from significant im- provements in clinical response and tolerability. This review examines the strategies for switching patients from conventional antipsychotic drugs to both oral and long-acting formulations of atypical antipsychotic drugs that are the recom- mended treatment in the majority of patients with schizophrenia.

Data Sources and Study Selection: An elec- tronic literature search of relevant studies using MEDLINE (January 1994–June 2004) was per- formed using the search terms antipsychotic, atypi- cal, conventional, schizophrenia, and switching. English-language articles, references from bibliog- raphies of reviews, original research articles, and other articles of interest were reviewed.

Data Extraction and Synthesis: Data quality was determined by publication in the peer-reviewed literature and the most important information iden- tified. Data from clinical trials suggest that switch- ing to an atypical antipsychotic drug is beneficial for the patient with schizophrenia.

Conclusions: If initiated appropriately, switch- ing to atypical antipsychotic medications should not compromise patient functioning; indeed, indi- vidualized strategies have been shown to provide continuous treatment efficacy. Switching to atypi- cal antipsychotic therapy should, therefore, be em- ployed as a pharmacologic strategy to maximize patient outcomes.

Prim Care Companion J Clin Psychiatry 2005;7:121-129 - Lien vers la source

Collège Méditerranéen de Psychiatrie