To compare the efficacy and tolerability of first- and second-generation antipsychotics (FGAs & SGAs, respectively) in the treatment of psychotic disorders.

PANSS scale was employed to measure disease severity and the efficacy of treatment. In all participants PANSS score was calculated on admission, before releasing the patient, and in case of any change in antipsychotic treatment schedule. Demographic data and comprehensive information on psychotropic medication status were collected for all patients.

377 patients (51,5% males) admitted to the Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, have been recruited for the study. Eighty two percent of participants were suffering from schizophrenia. The average improvement in PANSS score amounted to 22,85%. The demographic and clinical characteristics of patients being prescribed FGA or SGA were comparable. No statistically significant differences in the efficacy of FGAs vs SGAs, as well as mono- vs polytherapy were observed. SGAs were better tolerated than FGAs. A higher initial severity of symptoms was the only predictor of a major, over 40% improvement in PANSS score. FGA and SGA therapies proved equally effective in generating such substantial decreases in symptoms’ severity.

In our sample, the efficacy of FGAs and SGAs in the treatment of psychotic disorders was comparable. The tolerance of SGA therapy was better than for FGAs. Therapeutic success seems to be more dependent on adequate dosage than the class of an antipsychotic agent.