The primary objectives in the treatment of schizophrenia are to reduce frequency and severity
of psychotic exacerbation, ameliorate a broad range of symptoms, prevent relapses, and improve
functional capacity and quality of life. Treatment includes medication and a range of psychosocial
interventions. Antipsychotics are the cornerstone of pharmacological treatment for schizophrenia.
The twenty antipsychotics available in our country have traditionally been classified into two
major groups: first-generation (conventional) agents (FGAs) and second-generation (atypical)
agents (SGAs), although this dichotomization can be misleading. Whereas the efficacy of these
antipsychotic agents in the treatment of schizophrenia is broadly similar (with the exception
of clozapine’s greater efficacy in otherwise treatment-refractory patients), there are significant
differences in their side-effect profiles. Optimal individualized pharmacological treatment of
schizophrenia requires an understanding of the nature of schizophrenia (multiple pathological
dimensions, remitting and relapsing course), knowledge about the similarities and differences
between available antipsychotic treatments, and awareness of how to use these treatments
most effectively (targeted, measurement-based, individualized). In this paper, recent advances in
antipsychotic therapy are summarized and basic principles of the Florida Medicaid Drug Therapy
Management Program for the treatment of schizophrenia are articulated.