What Would The Patient Choose? Subjective Comparison of Atypical and Typical Neuroleptics

Introduction: Among the advantages of atypical antipsychotics, the lack of motor symptoms and the improvement of negative, affective, and cognitive symptoms are of clinical relevance. The aim of this study was to compare atypical and typical neuroleptics from the patient’s perspective. Method: To investigate differential efficacy and side effects of neuroleptics, 61 patients with schizophrenia or schizoaffective disorder, who have received typicals for 129 (± 194) and atypicals for 53 (± 68) weeks, were assessed. Results: There is strong evidence in favor of atypical neuroleptics in the domains negative (t = 7.7; P < 0.001), cognitive (t = 10.2; P < 0.001), and affective (t = 5.5; P < 0.001) symptoms. The assessment of atypicals and typicals regarding positive symptoms did not differ and may be an indication of the validity of the patient’s opinion. Regarding tolerability, atypical neuroleptics again are favored because of fewer motor, sexual, and vegetative side effects (t = 4.2; P < 0.001). Discussion: This study focusing on the subjective experience of patients provides further argument in support of the superiority of atypical over typical neuroleptics. The results of this study also point to the benefits of a consumer-orientated view.

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