The article you requested is
Reducing the Burden of Side Effects During Long-Term Antipsychotic Therapy: The Role of "Switching" Medications
J Clin Psychiatry 2007;68(suppl 6):14-23
© Copyright 2017 Physicians Postgraduate Press, Inc.
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One of the great challenges of long-term treatment of schizophrenia and related disorders is minimizing
the medical or psychological burden from persistent side effects. Because of the differences in side
effect profiles between the newer and older antipsychotic medications, and distinct differences among the
newer agents themselves, the spectrum of side effects associated with antipsychotic therapy has changed
tremendously. The authors review changing from one antipsychotic to another ("switching") as a potential
treatment strategy for reducing the overall side effect burden of antipsychotic therapy. This review identifies
6 steps to the evaluation of switching antipsychotics because of side effects: (1) Establish a causal
attribution that the clinical problem is an adverse effect of the antipsychotic medication; (2) Understand
the course of the side effect, especially regarding present and future risks for the individual patient receiving
the antipsychotic treatment; (3) Understand the potential risks and benefits of other side effect interventions
that do not require switching the antipsychotic; (4) Be aware of the side effect profiles of other
possible antipsychotics, with an understanding of the potential effectiveness of changing (switching) to
another antipsychotic for this side effect; (5) Calculate the side effect risks of switching antipsychotics;
(6) Calculate the efficacy risks of switching antipsychotics. The authors explain how to evaluate the specific
side effect in the context of the current medication and the overall management of the patient.