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";s:4:"text";s:3847:"Swartz, S.M. Lacks sedative properties as no M1 or H1 antagonism. By contrast, patients who are switched to long-acting injectable paliperidone or olanzapine can discontinue their oral pre-switch antipsychotic after receiving their first long-acting injection.Switching from oral antipsychotics other than olanzapine to long-acting injectable olanzapine, however, has not been systematically investigated, and patients should be closely monitored for postinjection sedation, neurological effects, and/or delirium after each olanzapine long-acting injection. Schuck, H. van den Ameele, P. Jaanson, V. Ryckmans, C. Hawley.Case histories illustrating the utility of sertindole in clinical practice.L. Perkins, Effectiveness of antipsychotic drugs in patients with chronic schizophrenia.Metabolism of atypical antipsychotics: involvement of cytochrome p450 enzymes and relevance for drug–drug interactions.Do novel antipsychotics have similar pharmacological characteristics? However, in vivo studies indicate that 2D6 is a minor metabolic pathway for olanzapine.From a pharmacodynamic standpoint, the affinity of the different antipsychotics for D2 dopaminergic, muscarinic cholinergic, histaminergic, and adrenergic receptorsPharmacodynamic aspects in switching between antipsychotics.APS: antipsychotic; ARI: aripiprazole; CLO: clozapine; EPS: extrapyramidals; OLA: olanzapine; QUE: quetiapine; RIS: risperidone; ZIP: ziprasidone.Despite the difficulties of using clozapine because of the monitoring required, this drug continues to play an essential role in treating schizophrenia because it is superior to other antipsychotics in resistant schizophreniaThe recommendations for switching from clozapine include:If possible, clozapine should be discontinued gradually by reducing the dosage 50The anticholinergics may prevent or alleviate clozapine withdrawal symptoms.Some case reports suggest that, if agranulocytosis is the reason for switching from clozapine, it is preferable to switch to an antipsychotic with a different receptor affinity profile—avoid switching to olanzapine or quetiapine, for example.Haematological controls should continue until at least 3–4 weeks after the clozapine was suspended.Overlapping should be used with caution in a switch involving subsequent treatment with chlorpromazine, haloperidol, or levopromazine because these drugs inhibit isoenzyme 2D6, one of clozapine's metabolic pathways.Although various switching strategy categorizations have been proposed,We do not have reliable data on which of the strategies is most commonly used. Swartz, R.A. Rosenheck, D.O. 997-1000D.E. For these patients, a lower initial dose (150A dosage reduction should be considered when more than 1 factor is present that could trigger a slowing of the metabolism (female sex, geriatric age, no tobacco habit). Green, A.C. Altamura, R. Anand, A. Bertoldi, Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT).Suicidal risk during treatment with clozapine: a meta-analysis.Clinical implications of clozapine discontinuation: report of an NIMH workshop.Switching from clozapine to olanzapine in treatment-refractory schizophrenia: safety, clinical efficacy, and predictors of response.Switching antipsychotics. It is important to point out again that these recommendations for specific clinical situations do not necessarily mean that this group of experts believes switching antipsychotics to be the best or only therapeutic option. At minimum, the patient and caregivers must be willing to switch medication and comply with more frequent patient visits during the early post-switch period. Caligiuri, R. Williams, P. Schieldrop, R. Manchanda, A. Malla, Reduction in neuroleptic-induced movement disorders after a switch to quetiapine in patients with schizophrenia.C.W. 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