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Sometimes, however, this is at the expense of worsening cognitive function. However, diet alone does not prevent SGA-induced weight gain; although weight loss has been demonstrated,no evidence of a positive dietary modulation of SGA-induced metabolic effects has thus far been evidenced. It is possible, however, that high heterogeneity and a relatively low quality of trials may have biased the results. Subjective measures are what matters most for current gold standards of outcome, and both negative and cognitive symptoms are more relevant here than the presence or absence of positive psychotic symptoms. For BD, the depressive polarity is most common and is also associated with a worse global outcome and with more functional impairment than is the presence of manic episodes.

These choices, to date, are mostly limited to careful clinical observation and assessment. Although modern, neurobiologically based instruments — such as pharmacogenetic tests or biomarker-based decision making — have been developed, they are only, as yet, partially implemented. They currently show guarded promise for optimal selection of individually tailored antipsychotic agents. Furthermore, information about long-term effects is limited since most trials are of short duration.

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Data on the incidence Womn potentially serious adverse effects NMS, agranulocytosis, diabetic ketoacidosis, pathological gambling, and pancreatitis and on long-term side effects eg, type 2 diabetes, TD, stroke, AMI, cancer, osteoporosis remain inconclusive. Long-term effects on fetuses exposed in utero to these drugs remain unknown. Using a framework that balances efficacy against target symptoms with the potential for behavioral toxicity, this review brings together what is currently known about the clinical use of antipsychotics. Methodologically improved clinical trials and large, prospective, longitudinal population-based observational studies will, in the future, fill the gaps described earlier and provide further evidence on the safety and tolerability of antipsychotic medications.

EV has received grants and served as a consultant, advisor, or CME speaker for the following entities:

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