Major new summary comparison of first generation (FGA) and second generation (SGA) antipsychotic medications for schizophrenia

"The results, featured in the monograph, showed few clinically significant differences between FGAs (predominately serotonin-dopamine antagonists) and SGAs (dopamine partial agonists) in treating either disease state. Only olanzapine, an SGA, demonstrated a clinically significant advantage over haloperidol, an FGA, in improving negative symptoms, scores on multiple rating scales, and general psychopathology of schizophrenia. For bipolar disorder, no drug class was superior to the other in terms of reducing manic and depressive symptoms.

With regard to adverse events, extrapyramidal symptoms were significantly more likely to be reported for FGAs—especially for haloperidol—than SGAs. The researchers could not draw conclusions regarding which class was more frequently associated with adverse metabolic health consequences, a common side effect of SGAs, due to insufficient studies in which the two classes were compared.

AHRQ noted that because differences between antipsychotic drugs may be clinically meaningful to patients on an individual basis, providers should make patients aware that “not every person responds in the same way to each medicine, and thus it may require trying several medicines before finding the most effective one.”

Full story here:
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1917578

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I think this full summary/ training might be available here:

https://ahrq.cmeuniversity.com/course/disclaimer/110304

Here is a summary that sounds very similar done a few years ago:

http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1053&PC=mhb

Also - related information here:

http://www.orpdl.org/durm/drug_articles/reviews/2013_11_21_FirstGenAntipsychotic_CR.pdf

http://www.orpdl.org/durm/meetings/meetingdocs/2014_01_30/archives/2014_01_30_AtypicalAntipsychoticClassUpdate_Final.pdf