Should the treatment of schizophrenia include old antipsychotic drugs?
Clozapine, although not suitable as a first-line drug, is superior to all other antipsychotics in terms of minimizing positive symptoms, reducing side effects, and treating treatment-resistant patients. There is little evidence that other newer drugs share these benefits. For certain patients it is not difficult to justify, on clinical grounds, the additional cost of prescribing clozapine. The case for prescribing one of the other newer drugs in preference to a traditional antipsychotic is often less clear-cut. Traditional antipsychotics clearly still have a role in the treatment of schizophrenia and they remain the authors’ preferred choice of first-line therapy.