Olanzapine is a broad-spectrum antipsychotic. Considering its low risk for EPS and TD and its advantages over ha-loperidol, as shown in the only published randomized, controlled trial of the novel agents in first-episode patients, olanzapine should be considered as first line therapy for recently diagnosed patients. However, olanzapine should be reserved as an alternative agent for overweight patients due to the risk of significant weight gain. Further research is required to determine its role in the management of treatment-resistant patients. Olanzapine has some anticholinergic effects that could limit its use in the elderly. birth control pills
Quetiapine is equally effective for the treatment of positive and negative symptoms of schizophrenia as chlorpromazine and haloperidol, and is superior to placebo. For negative symptoms, no difference in benefit from that of conventional antipsychotics has been identified. Small et al, in a placebo controlled trial evaluating low dose (mean dose 209 mg/day) and high dose (mean dose 360 mg/day) quetiapine, observed that negative symptom improvement was superior to placebo only in the high dose group. Long term stability of response has been evaluated in open label extension phases of acute treatment studies. At one year of follow-up, 33% of initial responders were still taking queti-apine, a result similar to that of olanzapine use at one year (38%). However, long term stability has not been shown to be superior to conventional agents.