정신병적 장애의 정신약물치료

Abstract

The discovery of antipsychotic medication has revolutionized the treatment of schizophrenia and other psychotic disorders. However, despite the enormous benefits provided by conventional antipsychotic medication, available compounds have several limitations. Firstly, they are not always effective. Secondly, their therapeutic effects are on positive symptoms and aggression, with less improvement noted in negative symptoms and cognitive functional status. Thirdly, conventional neuroleptics are generally associated with a variety of neurological adverse effects. So, they have limited efficacy in some patients, often resulting in a partial or no response. New approaches to antipsychotic treatment are illustrated by two novel drugs: risperidone for the treatment of psychotic disorders, and clozapine for patients with refractory schizophrenia or intolerance to conventional agents. These drugs appear to have some advantages over conventional antipsychotic agents, particularly in terms of reduced propensity to induce adverse neurological effects. Meanwhile, Conventional neuroleptics are being used more effectively and safely by tailoring the dosage to the individual patient. Strategies for improving response to conventional neuroleptics such as depot neuroleptics to improve compliance and the use of adjunctive benzodiazepines, lithium, anticonvulsants, or antidepressants are also being used. So, by the introduction of novel antipsychotics, prescribers must make more complex judgements about such issues as relative efficacy, adverse effects, and cost among several distinct agents. In this context, we addressed some clinical points and recommendations concerning the use of conventional and novel antipsychotic medications by reviewing some articles. And we showed some treatment strategies provided by some articles that employs conventional neuroleptics as well as the latest generation of novel antipsychotics