Sep 26, 2013

A review of the pharmacology, efficacy and tolerability of recently approved and upcoming oral antipsychotics: an evidence-based medicine approach

CNS Drugs
Leslie Citrome

Abstract

Evidence-based medicine (EBM) is a broad concept, but the key elements include the incorporation of clinical judgment (which requires clinical experience) together with relevant scientific evidence while remaining mindful of the individual patient's values and preferences. Using the framework and philosophy of EBM, this systematic review summarizes the pharmacology, efficacy, and tolerability of newly approved oral antipsychotics, including iloperidone, asenapine, and lurasidone, and outlines what is known about agents that are in late-stage clinical development, such as cariprazine, brexpiprazole, zicronapine, bitopertin, and EVP-6124. Potential advantages and disadvantages of these agents over existing antipsychotics are outlined, centered on clinically relevant issues such as the potential for weight gain and metabolic abnormalities, potential association with somnolence/sedation, extra-pyramidal side effects, akathisia, and prolongation of the electrocardiogram (ECG) QT interval, as well as practical issues regarding dosing instructions, titration requirements, and drug-drug interactions. Lurasidone appears to be best in class in terms of minimizing untoward alterations in body weight and metabolic variables. However, ilope...Continue Reading

  • References88
  • Citations39

References

  • References88
  • Citations39

Citations

Mentioned in this Paper

EVP-6124
Metabolic Process, Cellular
Antipsychotic Effect
Thyroid Hormone Metabolism, Abnormal
Schizophrenia
Weighing Patient
Lurasidone
Adverse Effects
Antipsychotic Agents
Controlled Clinical Trials, Randomized

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