Antipsychotics are mainstay treatment in schizophrenia; atypicals including clozapine were widely used. Clozapine was considered different due to its distinct effectiveness. We report the clinical profile of these groups.

In Nithsdale, South-west Scotland, the schizophrenia population was identified by ‘key informant’ method in 2006. The clinical variables were determined and compared between the groups.

The study identified 205 people with schizophrenia (point prevalence: 3.7/1000 general population) of which 131(64%) took part in the study. 22(17%) were receiving typicals, 63(48%) atypicals excluding clozapine, 29(22%) clozapine, 8(6%) combination of typical and atypicals, and 9(7%) were on no antipsychotic medications.

Comparison between atypicals excluding clozapine, typicals and clozapine groups showed: clozapine group were younger than atypicals and typicals (Mean years: 43,54 and 62, p=< 0.001). The length of illness was longer in typicals than atypicals and clozapine (Mean years: 35,24 and 18,p=0.002).

With mental state, clozapine group had higher score in positive subscore of PANSS than that of atypicals and typicals (Mean: 1.83,1.52 and 1.21, p=< 0.001); while there were no significant differences in the negative subscore (Mean: 2.11,2.01 and 1.77, p=0.24).

Tardive dyskinesia was more prevalent in typicals and clozapine groups than atypicals as assessed by AIMS scale (Mean: 41,41 and 18, p=0.02); while there were no significant differences between the three groups in the severity of parkinsonism as assessed by Simpson & Angus scale (Mean: 0.34,0.36 and 0.25, p=0.37).

Atypicals including clozapine were no better than typicals in symptom control or in the neurological side effect profile.