Atypical antipsychotics in the managed care era

Over the past decade, a new class of atypical antipsychotic drugs has been developed for the treatment of schizophrenia and related conditions. This new generation of antipsychotic agents represents the first significant breakthrough in the treatment of schizophrenia since the advent of chlorpromazine in the early 1950s. Although the designation "atypical" is currently the most widely used term for referring to these drugs, they are not likely to be viewed as atypical in the future--given their rapidly increasing use as first-line agents. Increased acceptance of these drugs early in the course of schizophrenia holds the promise of real long-term benefits in outcome. Although the acquisition cost of these drugs is significantly higher than that of older agents, pharmacoeconomic analysis suggests the possibility of substantial reductions in the overall financial burden posed by schizophrenic illness. This review summarizes the role of atypical antipsychotics in the treatment of schizophrenia, their merits compared to conventional medications, and their cost effectiveness.