Abstract

Until the early 1990s, first-line drug therapy for patients with acute schizophrenia was usually a traditional antipsychotic, such as haloperidol. As recently as 1997, we recommended that newer, so-called 'atypical' antipsychotic drugs, such as olanzapine and risperidone, should be reserved for patients unable to tolerate traditional drugs.1^,2 Now, atypical antipsychotics are widely regarded as better than traditional drugs, being generally less likely to cause troublesome extrapyramidal effects or hyperprolactinaemia.3^,4 Current atypical antipsychotics differ from one another in important respects. Here we consider how important differences in their unwanted-effect profiles may influence the choice between these drugs for patients with schizophrenia.