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ASCP Corner: All Antipsychotics Are Equal, but Some Are More Equal Than Others

J Clin Psychiatry 2009;70(3):429-430
10.4088/JCP.09ac05081

One of the “atypical” features of second-generation antipsychotics (SGAs) that was quickly appreciated by clinicians and patients shortly after their introduction was that these medications were shown to elicit fewer extrapyramidal side effects than the first-generation antipsychotics (FGAs). Early head-to-head comparisons of some first-line SGAs with FGAs in patients with schizophrenia also demonstrated better efficacy in terms of overall symptom reduction in studies comparing risperidone and olanzapine with haloperidol. However, later studies failed to demonstrate the superiority of SGAs over FGAs in effectiveness or safety.