Antipsychotic Medications: Enhancing Use to Improve Outcomes

Abstract and Introduction

Introduction

The search for more effective and better-tolerated antipsychotics continues, a strategy that is important but also challenging.^[1,2] In the meantime, we still have much to learn regarding the drugs currently available and it would be unfortunate if we do not continue to address these gaps in knowledge. Almost 70 years of experience with antipsychotics suggests that there is little left to know regarding optimal clinical use. Regretfully, this is not the case—there remain numerous questions regarding clinical use as basic as dose, dosing, and switching. We highlight this point with recent evidence that advances our knowledge in these areas, at the same time calling into question current strategies that arguably have achieved the status of clinical dogma.

Authors and Disclosures

Hiroyoshi Takeuchi*^,1,2, Stefan Leucht³, John M. Kane^4,5, Ofer Agid^2,6,7 and Gary Remington^2,6–8

¹Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; ²Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; ³Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany; ⁴Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY; ⁵Department of Psychiatry, Donald and Barbara Zucker School of Medicine, Hempstead, NY; ⁶Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; ⁷Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; ⁸Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada

*To whom correspondence should be addressed
Department of Neuropsychiatry, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; tel: +81-3-3353-1211 (ext. 62454), fax: +81-3-5379-0187, e-mail: hirotak@dk9.so-net.ne.jp

H.T. has received speaker's fees from EA Pharma, Kyowa, Janssen, Meiji Seika Pharma, Mochida, Otsuka, Sumitomo Dainippon Pharma, and Yoshitomiyakuhin. S.L. has received honoraria as a consultant/advisor and/or for lectures from Angelini, Boehringer Ingelheim, Geodon Richter, Janssen, Johnson & Johnson, Lundbeck, LTS Lohmann, MSD, Otsuka, Recordati, SanofiAventis, Sandoz, Sunovion, TEVA. J.M.K. has been a consultant or received honoraria from Acadia, Alkermes, Intracellular Therapies, Janssen, LB Pharma, Lundbeck, Merck, Minerva, Neurocrine, Otsuka, Roche, Saladex, Sumitomo Dainippon, Sunovion, Takeda and Teva. He has received grant support from Janssen, Lundbeck and Otsuka. He is a shareholder of LB Pharma and Vanguard Research Group. O.A. has received advisory board or consultant fees from Janssen-Ortho (Johnson & Johnson), Otsuka, Lundbeck, Sumitomo Dainippon Pharma, and Minerva Neurosciences; speaking engagement fees from Janssen-Ortho (Johnson & Johnson), Lundbeck, Otsuka, Mylan Pharmaceuticals, HLS Therapeutics, and Medscape; research contracts from Janssen-Ortho (Johnson & Johnson), Otsuka, Boehringer Ingelheim, Neurocrine Bioscience, Acadia, Syneurx, and DiaMentis. G.R. has received research support from HLS Therapeutics. He has received advisory board support from HLS Therapeutics and consultant fees from Mitsubishi Tanabe Pharma.

Funding
None declared.