do they still use the old typical antipsychotics?

[thelost]

the atypicals are being seen as bigger and better than the typicals with less side effects but do pdocs still have a use for the typical aps or are they being phased out to the point where no one uses them anymore? plz explain ur answers.

[Moil]

My understanding is that the side effects for them tend to suck worse so they tend to use them only if the atypicals don't work.

[thelost]

My understanding is that the side effects for them tend to suck worse so they tend to use them only if the atypicals don't work.

if nothing works they usually give you clozapine. but clozapine is an atypical?

[Moil]

I guess it was the first atypical apparently it comes with that unpleasant blood condition.  I just looked it up strangely enough. 

I'm gonna have to poke around some more...I kinda want an answer with references now...

[Moil]

Found something:

There was no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile.

The typicals also don't come with white picket fences or butterflies...but they to carry the baggage of being nicknamed chemical libodomies.

[nibblerd]

In my area, they are used as a last-resort for patients that do not respond to atypicals or other medications. However, they are still widely used in the hospital setting, like when I was given Haldol for being aggressive. I assume that was for its intense sedation. It worked, and I don't have parkinsons' from it, but the typicals have side effects that mean they are used less than the atypicals. The atypicals can also cause EPS but in general, it happens less.

Edit: Though there is not a clinical difference in efficacy between the typicals and atypicals on a large scale, on a per-patient basis it is totally feasible to respond better to one specific medication over the other, whether it be typical, atypical, or something else.

[Moil]

Well Chlorpromazine was developed as an anesthetic...so I guess you you could have them sleep it off if it doesn't relieve the symptoms being targeted.

[thelost]

Found something:

There was no evidence for differences in efficacy between atypical and typical antipsychotics, but there was a clear difference in the side-effect profile.

The typicals also don't come with white picket fences or butterflies...but they to carry the baggage of being nicknamed chemical libodomies.

hang on hang on i thought atypicals were more effective at treating the negative symptoms of schizophrenia than the old aps? if true they really are more effective than the typicals?

[vanderk]

The atypicals are honestly not more effective than the older agents. As said before, just less likely to cause EPS or TD. But they still can. I've seen a number of folks who truly do better on the older meds, especially when fixed delusions are a primary symptom. And I've dealt with quite a few folks who don't need an antiparkinsonian on board with Prolixin. What bugs me is when we get folks coming out of the hospital on atypicals, especially the newest and shinest, with no ability to continue due to a lack of Medicaid/Medicare or other payment source. My state also refuses to pay for Sustena, Saphris and Fanapt. We try to convey this message to the local IP units, to no avail.

[mika]

I am better off with typicals. I have tried every atypical besides zyprexa. I had a lot of crazy Side effects. Weight gain is my biggest issue along with eps and Td symptoms.

However haldol and large amounts of trilafon gave me a paralyzed bladder. But once I decreased the typical, I was fine.