Atypical Antipsychotics (Cont.)

Atypical Antipsychotics and Negative Symptoms

Traditionally, it was also thought that newer, atypical antipsychotics were more effective for "negative symptoms" of schizophrenia. Negative symptoms include:
 
  • Lack of speech
  • "Flat" facial expression or personality
  • Not caring about things (apathy)
  • Lack of pleasure in normally pleasurable activities.
     
Research seems to support the conclusion that newer medications are better for negative symptoms, although there is significant controversy surrounding this issue as well.
 

Atypical Antipsychotics and Weight Gain

Atypical antipsychotics appear to increase the risk of weight gain. Sometimes, this weight gain can be extreme (as much as 75 to 100 pounds or even more). It is not known exactly how or why atypical antipsychotics cause weight gain.
 
Along with weight gain comes a host of other health risks, such as heart disease, diabetes, or even arthritis. Much research has focused on atypical antipsychotics and diabetes, suggesting a definite link between the two.
 

Choosing an Atypical Antipsychotic Medication

More than with medications for other medical conditions, there is wide variation in how individuals respond to different antipsychotic medications. Often, a "trial and error" approach must be used, trying different antipsychotics (or combinations of antipsychotics) until the best medication for an individual is found. What works best for one person may not be what works best for the next person.
 
Most healthcare providers that deal with psychotic disorders are familiar with the results of the CATIE trial (which is changing the way people think about treating schizophrenia) and are more than willing to discuss this important study with their patients.
 

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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;