The atypical antipsychotics are a group of antipsychotic drugs introduced after the 1970s and used to treat psychiatric conditions. Some atypical antipsychotics have received regulatory approval for schizophrenia, bipolar disorder, as an adjunct in major depressive disorder. Both generations of medication tend to block receptors in the brain's dopamine pathways. Atypicals are less than haloperidol — the most used typical antipsychotic — to cause extrapyramidal motor control disabilities in patients such as unsteady Parkinson's disease-type movements, body rigidity, involuntary tremors. However, only a few of the atypicals have been demonstrated to be superior to lesser-used, low-potency first-generation antipsychotics in this regard; as experience with these agents has grown, several studies have questioned the utility of broadly characterizing antipsychotic drugs as "atypical/second generation" as opposed to "first generation," noting that each agent has its own efficacy and side-effect profile.
It has been argued that a more nuanced view in which the needs of individual patients are matched to the properties of individual drugs is more appropriate. Although atypical antipsychotics are thought to be safer than typical antipsychotics, they still have severe side effects, including tardive dyskinesia, neuroleptic malignant syndrome, increased risk of stroke, sudden cardiac death, blood clots, diabetes. Significant weight gain may occur. Critics have argued that "the time has come to abandon the terms first-generation and second-generation antipsychotics, as they do not merit this distinction." Atypical antipsychotics are used to treat schizophrenia or bipolar disorder. They are frequently used to treat agitation associated with dementia, anxiety disorder, autism spectrum disorder, obsessive-compulsive disorder. In dementia, they should only be considered after other treatments have failed and if the patient is a risk to themselves and/or others; the first-line psychiatric treatment for schizophrenia is antipsychotic medication, which can reduce the positive symptoms of schizophrenia in about 8–15 days.
Antipsychotics only appear to improve secondary negative symptoms of schizophrenia in the short term and may worsen negative symptoms overall. Overall there is no good evidence that atypical antipsychotics have any therapeutic benefit for treating the negative symptoms of schizophrenia. There is little evidence on which to base a risk and benefit assessment of using antipsychotics for long-term treatment; the choice of which antipsychotic to use for a specific patient is based on benefits and costs. It is debatable whether, as a class, atypical antipsychotics are better. Both have equal drop-out and symptom relapse rates when typicals are used at low to moderate dosages. There is a good response in 40–50% of patients, a partial response in 30–40%, treatment resistance in the remaining 20%. Clozapine is considered a first choice treatment for treatment-refactory schizophrenia in the short term; the utility of broadly grouping the antipsychotics into first generation and atypical categories has been challenged.
It has been argued that a more nuanced view, matching the properties of individual drugs to the needs of specific patients is preferable. While the atypical antipsychotics were marketed as offering greater efficacy in reducing psychotic symptoms while reducing side effects than typical medications, the results showing these effects lacked robustness, the assumption was challenged as atypical prescriptions were soaring. In 2005 the US government body NIMH published the results of a major independent multi-site, double-blind study; this study compared several atypical antipsychotics to an older typical antipsychotic, among 1,493 persons with schizophrenia. The study found; the authors noted an apparent superior efficacy of olanzapine to the other drugs in terms of reduction in psychopathology and rate of hospitalizations, but olanzapine was associated with severe metabolic effects such as a major weight gain problem and increases in glucose and triglycerides. No other atypical studied did better than the typical perphenazine on the measures used, nor did they produce fewer adverse effects than the typical antipsychotic perphenazine, although more patients discontinued perphenazine owing to extrapyramidal effects compared to the atypical agents.
A phase 2 part of this CATIE study replicated these findings. Compliance has not been shown to be different between the two types. Overall evaluations of the CATIE and other studies have led many researchers to question the first-line prescribing of atypicals over typicals, or to question the distinction between the two classes, it has been suggested that there is no validity to the term "second-generation antipsychotic
Janusz Kazimierz Zawodny was a Polish-American historian, political scientist, World War II soldier and resistance fighter of the Polish Underground State. Zawodny fought in the Polish Army during World War II during the Invasion of Poland with the underground Home Army resistance movement, he took part as a second lieutenant in the 1944 Warsaw uprising during the September campaign, first a soldier of the ZWZ the AK. In the Warsaw Uprising he was a platoon commander of a battalion AK "Lukasiriski", replaced the commander of the companies "Cost" in the group the "Pine" at the Old Town. In the street fighting against Waffen-SS troops, he was twice wounded: once in the hand by submachine gun fire at point-blank range, once to his face and ear by schrapnel after he recovered, threw back, a live German grenade, tossed into the bunker he and his men were sheltering in. After the uprising, he was captured and became a prisoner of war in Oflag VII-A Murnau under a different name, "Turczyk", as he was wanted by the Gestapo beginning in April 1944.
After liberation from Murnau, he joined the Second Polish Army Corps in Italy, where he commanded a battalion of heavy armored cars in the 12th Podolian Uhlan Regiment. After the war, he continued his military service with Polish Second Corps; when the Soviet Union took control of the country, creating the People's Republic of Poland, he decided to stay abroad and emigrated to the United States residing in Washington state until his death in 2012. He earned his PhD in 1955 at Stanford University, he went on to teach at Princeton University, University of Pennsylvania, St Antony's College, Claremont Graduate University and Pomona College. He was a member of the Institute for Advanced Study Princeton, he served as an advisor to the National Security Council for the Carter and Reagan presidential administrations. Death in the Forest: The Story of the Katyn Forest Massacre Nothing but Honor: The Story of the Warsaw Uprising, 1944 Man and International Relations: Contribution of the Social Sciences to the Study of Conflict and Integration and Contributor.
Guide to the Study of International Relations The Warsaw Uprising in Combat and Diplomacy Participants and Witnesses of the Warsaw Uprising. Interviews Motyl na Śniegu History Award, The J. Pilsudski Institute, New York, 1997 Literary Award, Paris 1981 Gold Medal and Life Membership, Medicus Association Doctors of Medicine, for "Interdisciplinary Research," New York, 1980 2003 laureate honor "Guardian of National Remembrance" from Poland's Instytut Pamięci Narodowej Virtuti Militari Polonia Restituta by President Aleksander Kwaśniewski on 6 September 1996 "in recognition of outstanding merit in activities for Poland" Order of Merit of the Republic of Poland from President Lech Walesa on 9 March 1994 "for outstanding merit in journalism" Cross of Valor Gold and Silver Crosses of Merit with Swords British War Medal 1939–45. List of Poles Short bio at Józef Piłsudski Institute of America Short bio at IPN site A compiled film of Professor Zawodny's visit to Poland in 2006 on YouTube
Giuseppe Moruzzi was an Italian neurophysiologist. He was one of three scientists who connected wakefulness to a series of brain structures known as the reticular activating system, his work reframed sleep as an active process in the brain rather than a passive one, he received the Karl Spencer Lashley Award from the American Philosophical Society and the Feltrinelli Prize from the Accademia dei Lincei. Born in Campagnola Emilia, Moruzzi grew up in Parma, he came from a line of physicians. Moruzzi studied at the University of Parma under neuroanatomist Antonio Pensa, trained by Camillo Golgi. Pensa left to work in Pavia, but Moruzzi stayed behind, in part because he could not afford to move away from home but because his interests had shifted from neuroanatomy to neurophysiology. Mario Camis mentored Moruzzi, Moruzzi followed him to Bologna in 1936. Beginning in 1937, Moruzzi studied under Frederic Bremer at the Neurophysiologic Institute at the University of Brussels, he worked at the Neurophysiological Institute of Cambridge under Edgar Adrian, where the pair became known for recording discharges from single motor neurons in the pyramidal tracts.
In the years following World War II, many European scientists relocated to the United States. Moruzzi came to Northwestern University to work with a brain scientist named Steven Ranson. Once at Northwestern, Moruzzi met Horace Winchell Magoun and Donald B. Lindsley, they worked to elucidate the neural processes responsible for wakefulness; until the 1940s, some scientists felt like wakefulness required an adequate level of sensory input rather than a specific process inside the brain. In a 1949 experiment with a cat and Magoun proved that stimulation of a certain brain region created a state of alertness; this stimulated area of the brain became known as the reticular activating system or reticular formation. In their experiments and Magoun transected the cat's reticular formation without disrupting any of the sensory nerves; the experiment shifted science's conception of sleep from a passive process to one, controlled by the brain. The "Moruzzi school of physiology" helped to develop a generation of Italian scientists.
Giovanni Berlucchi received early research training as a postdoctoral fellow with Moruzzi, he became one of the most eminent Italian neurophysiologists. Moruzzi influenced scientists like Giacomo Rizzolatti, Arnaldo Arduini, Lamberto Maffei and Piergiorgio Strata. In 1965, Moruzzi won the Karl Spencer Lashley Award from the American Philosophical Society, he was awarded the Feltrinelli Prize from the Accademia dei Lincei, he received honorary degrees from several universities in the United States and Europe, including the University of Pennsylvania and the University of Lyon. In 1981, Moruzzi became a founding member of the World Cultural Council. Moruzzi was diagnosed with Parkinson's disease late in life. In a 1990 speech, Nobel laureate Rita Levi-Montalcini said that Moruzzi had been more deserving of the 1986 Nobel Prize, awarded to her