Personally, I prefer risperidone and olanzapine over chlorpromazine or
haloperidol any
time. But only because I haven't tried quetiapine or clozapine. How about you?

~~~~~~~~~~~~~~~~~~~~~~~~~~

Dispute over schizophrenia drugs

Older schizophrenia drugs may be as effective as the new generation of
medications,
experts have suggested.

A Manchester University study shows patients respond just as well, and perhaps
better, to
the older ones.

The Archives of General Psychiatry findings run contrary to the widely held view
that newer
and dearer drugs are safer and more effective.

But critics say the newer drugs are better and preferred by patients because
they have
fewer side effects.


"Second-generation anti-psychotics are not the great breakthrough they were once
thought to be"
Professor Shôn Lewis


The new UK results back similar work by US investigators who recently suggested
it might
be better to switch back to prescribing the older drugs to cut healthcare costs.

The NHS funded the latest work to assess whether the bigger price tag of newer
"atypical"
antipsychotics was offset by improvements in patients' quality of life or
reductions in the
use of health and social care services.

Atypical antipsychotics, which include risperidone, quetiapine, clozapine and
olanzapine,
cost at least 10 times more than their predecessors.

No advantage

The Manchester team, along with colleagues from the University of Cambridge,
Institute of
Psychiatry and Imperial College London, studied 227 schizophrenia patients for
whom a
change in drug treatment was being considered because of ineffectiveness or
harmful side
effects.

Experienced doctors decided which type of antipsychotic - newer or older - would
be best
for each patient.

The patients were assessed before and 12, 26 and 52 weeks after their drugs were
switched, using measurements of quality of life, symptoms, side effects, and
satisfaction
with the drug.

Overall, the newer atypical drugs showed no advantage in side effects or
effectiveness.

Lead researcher Professor Shôn Lewis suggested further trials to evaluate the
usefulness of
cheaper, older drugs could potentially save the NHS millions of pounds.

He said: "Despite modern prescribing patterns, second-generation anti-psychotics
are not
the great breakthrough they were once thought to be - and certainly may not
justify their
10-times higher price tag."

A parallel trial, also funded by the NHS, did confirm previous reports that one
newer
antipsychotic called clozapine stood out from the other atypicals for treating
severe
schizophrenia.

Informed choice

Jo Loughran, of the mental health charity Rethink, said both types of drugs old
and new
could bring different benefits and side effects for different people.

She said: "Atypical antipsychotic medicines should always be considered in the
first-line
treatment of schizophrenia, and patients should be offered an informed choice of
medicines to suit them."

The government's drugs watchdog NICE echoes this advice.

However, it also says people with schizophrenia who are already taking an older
antipsychotic which is working for them should not switch to a newer drug.

Marjorie Wallace, chief executive of the mental health charity SANE, warned it
would be
wrong to limit accessibility to news anti-psychotics.

"What we hope is that the study will flag up the importance of patients being
able to look
at the risks and benefits of different drugs, matched to their own biochemistry,
and that it
will encourage the pharmaceutical companies in their current research to develop
third-
generation medications."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/6175992.stm

Published: 2006/11/24 10:18:31 GMT

© BBC MMVI