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Tijdschrift voor Psychiatrie 48 (2006) 1, 45 - 51

Short report

Should we prescribe at first a conventional or a atypical antipsychotic?

H.H. Harms

The pharmacotherapy advice contained in the 'Multidisciplinaire Richtlijn Schizofrenie 2005'(abbreviated to mdrs 2005 and translated as the Dutch Multidisciplinary Schizophrenia Guideline) is compared with the advice given in the 'Farmacotherapeutisch Kompas 2005' (abbreviated to ftk 2005 and translated as the Pharmacotherapy Compass 2005) and with international guidelines. ftk 2005, which is the Dutch National Health Insurance Formularium, recommends that treatment should start with a conventional (first-generation) antipsychotic, namely haloperidol. International guidelines, however, advise starting with an atypical (secondgeneration) antipsychotic. mdrs 2005 suggests that the pros and cons of the medication should be discussed with the patient and that the choice of drug should be based on the outcome of this discussion. If that discussion becomes problematical then, according to mdrs 2005, it is advisable to opt for an atypical antipsychotic.


keywords antipsychotic agents, first choice, guideline, schizophrenia