Are Atypical Antipsychotics Really Better Than Neuroleptics?

Although all second-generation antipsychotics share an improved adverse-effect profile, they evince different levels of efficacy.

Physicians agree that atypical antipsychotic medications are better tolerated than the first-generation antipsychotics (i.e., neuroleptics); there is less consensus about efficacy. Are these newer medications more effective than neuroleptics in treating schizophrenia? If so, are the individual atypicals similarly effective? These questions were addressed in a meta-analysis of 142 randomized, controlled, efficacy studies (124 studies comparing neuroleptics with atypicals and 18 studies comparing atypicals). Effect sizes were used to examine differences across studies.

Individually, clozapine, risperidone, and olanzapine were significantly more effective than the comparison neuroleptics. Clozapine was superior to haloperidol, with an effect si…

Reviewing Author

Steven Dubovsky, MD