In 10-15 years, do you believe Olanzapine, Quetiapine, and Risperidone will continue to be the staples of Inpatient psychiatric management, or do you think there will be a shift to new antipsychotics such as Cariprazine, Lurasidone and Lumateperone in the coming decade?
In my practical experience, I have seen clozapine resistant schizophrenia patient to respond with Lurasidone. Regarding Cariprazine, though it acts on negative symptoms very little but till better than other available options. Both the drug has potent D2 blocking activity and potential to cause Extrapyramidal symptoms. In India both are underused due to cost compared to other antipsychotic like olanzapine Or Risperidone. Yes, I hope in better near future for them.
In my experience with psychiatric drugs of all kinds, they are effective when relatively new because of high patient and clinician expectations that are based, in large part, on the company's marketing skills. After a while these new drugs are judged to be more or less as effective as older drugs for the same indication, but with fewer adverse effects. As more time goes by, the adverse effects of the newer drugs become increasingly apparent and expectations turn to the promise of the next generation of similar drugs.
Rarely (usually serendipitously} a real breakthrough medication does come along.
Currently the drug companies are all pursuing drugs that affect glutamate receptors.
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