Objective: To evaluate trends in the use of antipsychotic drugs in Lithuania between 2003 and 2005 years. Methods: The data on total sales of antipsychotic drugs in all Lithuanian regions over three years (2003-2005) were obtained from IMS Health Inc. Drugs were classified according to the Anatomic Therapeutic Chemical system and use was quantified in terms of defined daily doses. Meta-analysis of observational studies retrieved through systematic search of all available electronic data sources. 1651 abstracts were found and checked. 76 randomised double-blind studies were identified for the met-analysis. Data were calculated by DDD methodology and expressed in DDDs per 1.000 inhabitants per day. The pharmacoeconomic analysis of antipsychotics was performed by cost minimization and reference price methodology. Results: In Lithuania the total antipsychotics consumption increased by 16% over three years (2003-2005) period reaching the value of 5,5 DDD/1000 inhabitants/day. Since 2003 the proportion of use of conventional antipsychotics has increased by 2%, while the use of atypical antipsychotics has increased by 14%. The expenditures of antipsychotics has reached 39 mln Litas (in 2005), of which 48% was costs for atypical antipsychotic agents. Setting the reference price of risperidone (according to the meta-analysis results of effectiveness) for atypical antipsychotics it would be possible to rationalize schizophrenia treatment using 10,68 mln Litas extra money. Conclusions:... [to full text]