[Second generation of neuroleptics--expectations and the reality]

The expectations regarding the successful treatment of psychotic disorders, especially schizophrenia, are quite high. By introduction of the antipsychotic drugs of second generation, the hope of better efficacy and tolerability has arisen. Up to now, basing on the clinical experience it seems that the efficacy of II generation antipsychotics reflects not only the positive but also the negative as well as affective schizophrenic symptoms. These drugs do not worsen the cognitive functioning of patients, but sometimes even improve some cognitive functions. Their tolerability is in general better in comparison to the classic neuroleptics, but sometimes it happens that unfavorable drug-induced side-effects during treatment (e.g. extrapyramidal symptoms) may occur. The careful selection of the drug and its dosage increases the possibility of good clinical improvement, but more wider use of these drugs is recommended in order to evaluate their practical usefulness.