Kuperberg G R, Murray R
Maudsley Hospital, London.
Br J Clin Pract. 1996 Sep;50(6):315-23.
We review advances in the treatment of schizophrenia. We begin with an overview of antipsychotic drug development, focusing on the in vitro and in vivo binding profiles of clozapine and a new generation of D2:5HT antagonists. We then consider the main barriers to effective treatment: non-compliance (and side-effects) of medication, recurrent relapse, 'treatment resistance', negative symptoms and neurocognitive deficits. Within this framework, we review the mechanisms of action and clinical uses of the 'atypical' antipsychotic drugs. We also show how a variety of psychosocial interventions, particularly those that incorporate cognitive techniques, can be used in combination with pharmacotherapy to overcome the same clinical hurdles.