First generation antipsychotic drugs as effective as newer ones in som...( CHAPEL HILL Nearly every child who r...),Health

CHAPEL HILL Nearly every child who receives an antipsychotic medicine is first prescribed one of the second-generation, or atypical drugs, such as olanzapine and risperidone. However, there has never been evidence that these drugs are more effective than the older, first-generation medications.

Now a study from the University of North Carolina at Chapel Hill School of Medicine suggests that molindone, a first-generation drug, is as effective as the newer ones and should be used as a first line of therapy in some children with schizophrenia or schizoaffective disorder.

People thought the second-generation drugs were superior because they had no side effects. We found that molindone works as well as newer drugs, and in some cases its safer, said Lin Sikich, M.D., associate professor in the department of psychiatry at UNC and lead author of the study, titled the Treatment of Early-Onset Schizophrenia Spectrum Disorders Study.

The guidelines are going to have to be rewritten because of this study, Sikich said. A report of the study is published Monday in the Sept. 15, 2008 edition of the American Journal of Psychiatry. Co-author Jeffrey Lieberman, M.D., led the earlier CATIE trial at UNC, a landmark study that compared antipsychotic medications in adults. Lieberman is now at Columbia University Medical Center.

The study is the largest head-to-head trial comparing the newer drugs, which became available in the 1990s, to the older ones, which have been around since the 1950s.

Between 2002 and 2006 the study randomly assigned 119 people aged 8 to 19 years to receive molindone, olanzapine or risperidone over an eight-week period at four sites: UNC; McLean Hospital and Cambridge Health Alliance at Harvard Medical School; Seattle Childrens Hospital and the University of Washington; and Case Western Reserve University.

A decline in symptoms was similar across the three medications. But the drugs caused very different types of s
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