[Re-evaluating neuroleptics: their antipsychotic properties?]

ANTIPSYCHOTIC PROPERTIES: Compared with traditional neuroleptics, antipsychotics affect receptors other than dopaminergic receptors, particularly serotonin receptors. Clinically, antipsychotics have little or no extrapyramidal effects and do not induce late dyskinesia. They are effective for productive symptoms. It is more difficult to evidence their antideficiency effect. Antipsychotics can improve certain cases of resistant schizophrenia. LIMITATIONS OF NEUROLEPTICS: Clinical response to traditional neuroleptics is not really satisfactory for approximately one quarter of the patients. In addition, problems of tolerance, particularly neurological disorders, are important. ATYPICAL NEUROLEPTICS: Sulpiride can be considered as a precursor. Amisulpride is a more recent derivative. Clozapine, risperidone and olanzapine are also distributed in France. Other compounds should be available soon. UNRESOLVED QUESTIONS: The long-term effect of these new drugs, whether similar to or superior to classical compounds, remains to be determined as well as their long-term safety profile. In addition, due to high cost, first line use of these new antipsychotics requires a cost/ benefit analysis.