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Study Shows Older, Cheaper Drug is Effective as Newer Antipsychotic Meds

Brief Description:
An 18-month look at the effectiveness of drugs used in the treatment of schizophrenia showed that it's not always the newest and most expensive drugs that work the best.

Transcript:
Schmalfeldt: An 18-month look at the effectiveness of drugs used in the treatment of schizophrenia showed that it's not always the newest and most expensive drugs that work the best. In the Clinical Antipsychotic Trials of Intervention Effectiveness study — known by its initials "CATIE" — researchers compared the effectiveness of three newer antipsychotic medications with a medication available since the 1950s. Dr. Jeffrey Liebermann of Columbia University Medical Center was principal investigator of the CATIE study. He shared the surprising results.

Lieberman: The biggest surprise of the study was that the older medication perphenazine was comparably effective to at least three of the new medications, and not much worse than the new drug which did the best — olanzapine. Contrary to expectations, the older medication did not cause substantially more neurology, Parkinsonian side effects than the new drugs.

Schmalfeldt: Dr. Lieberman said the newer drug olanzapine — which is sold under the brand name Zyprexa — did a somewhat better job of controlling hallucinations, delusions and disordered thinking, but that it had a higher risk of causing metabolic changes in a patient, including type 2 diabetes. The newer generation of medications, known as atypical antipsychotics, roughly cost up to 10 times as much as the older medication. The CATIE results mean that when taken as a whole, the newer, more expensive medications used to treat schizophrenia have no substantial advantage over the older medication used in the study. Doctor Thomas Insel, is director of the National Institute of Mental Health, which funded the study.

Insel: Today, about 90 percent of prescriptions for antipsychotics belong to this new generation of drugs. Collectively, this has become the fourth largest group of drugs prescribed in the United States at a cost of roughly $10 billion in 2005, and probably in excess of 50,000 prescriptions.

Schmalfeldt: The report, published in the September 22 issue of the New England Journal of Medicine, is the first phase of outcomes from the CATIE study. Future reports are expected to provide a more detailed picture of the interaction between patient characteristics, medication, and outcomes. From the National Institutes of Health, I'm Bill Schmalfeldt in Bethesda, Maryland.

This page was last reviewed on September 30, 2005 .

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