Navigation Links
Older Antipsychotics May Work as Well as Newer Ones: Review
Date:8/14/2012

By Denise Mann
HealthDay Reporter

TUESDAY, Aug. 14 (HealthDay News) -- Newer, more expensive schizophrenia medications are not noticeably better than their older, cheaper counterparts, a new review suggests.

Currently, 75 percent of U.S. adults who are prescribed antipsychotic medications take these second-generation drugs, which were developed largely due to concerns about side effects with their predecessors, experts noted.

First-generation antipsychotics are also called typical antipsychotics. This class of drugs includes chlorpromazine (Thorazine), haloperidol (Haldol), perphenazine (Etrafon, Trilafon) and fluphenazine (Prolixin). Second-generation drugs, known as atypical, antipsychotics include risperidone (Risperdal), aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine Fumarate (Seroquel) and ziprasidone (Geodon). There is a major cost difference between the two classes of drugs: For example, a month's supply of olanzapine can cost $546, while a month's supply of haloperidol ranges from $18 to $27, according to Consumer Reports.

But are these newer drugs really more effective or less risky? Researchers at the U.S. Agency for Healthcare Research and Quality reviewed 114 studies involving 22 comparisons between the two classes of drugs to answer these questions. Their review appears in the Aug. 14 issue of the Annals of Internal Medicine.

The review found that the second-generation antipsychotics are not much better than the earlier incarnations at treating positive symptoms associated with schizophrenia. "Positive symptoms" is the umbrella term for symptoms of psychosis such as delusions and hallucinations. By contrast, negative symptoms reflect a decrease or loss of normal function including expression or speech.

Two second-generation drugs, olanzapine and risperidone, did seem to be more effective at treating negative symptoms when compared with the older haloperidol, the investigators said.

There was insufficient evidence to compare risk profiles between the two classes of drugs, the researchers said. Long-term risks of antipsychotics may include diabetes, major metabolic syndrome and a neurological disorder that causes involuntary, repetitive movements (tardive dyskinesia). Metabolic syndrome refers to a cluster of risk factors that increase risk for diabetes and heart disease.

"The typical antipsychotics that have been around for a long time are just as good at treating schizophrenia symptoms as the newer ones," said Dr. Dolores Malaspina, director of the Institute for Social and Psychiatric Initiatives at NYU Langone Medical Center in New York City. In the future, doctors may adopt a personalized medicine approach to better pair treatments with individual symptoms and disease manifestations, she suggested.

Until then, "my first choice would be to try one of the medications that have a longer track record, and then move on if need be," Malaspina said, adding that the main differences between the first- and second-generation medications are side effects.

Commenting on the review, Dr. David Straker, an adjunct assistant clinical professor of psychiatry at Columbia University Medical Center in New York City, said: "The newer drugs seem to be more effective with negative symptoms and, as such, they help with concentration and focus, but they cost a lot more and may have more metabolic side effects. It comes down to weighing the risks versus the benefit in each individual patient."

And, according to Dr. Roberto Estrada, a psychiatrist at Lenox Hill Hospital in New York City, the review raises an important issue that psychiatrists face in treating people with schizophrenia.

"The limitations of first-generation antipsychotics were well known prior to the introduction of second-generation antipsychotics, but now the metabolic issues and expense associated with using second-generation antipsychotics has created further challenges in the treatment of schizophrenia," Estrada said.

The new review "is unable to draw clear conclusions about differences between the two in the treatment of schizophrenia," Estrada explained. "However, in clinical practice using the second-generation drugs, we see comparable symptom management with little acute adverse effects, but different and equally long-term adverse effects."

More information

Learn more about schizophrenia at the U.S. National Institute of Mental Health.

SOURCES: Dolores Malaspina, M.D., professor, psychiatry, and director, Institute for Social and Psychiatric Initiatives, NYU Langone Medical Center, New York City; Roberto Estrada, M.D., psychiatrist, Lenox Hill Hospital, New York City; David Straker, D.O., adjunct assistant clinical professor, psychiatry, Columbia University Medical Center, New York City; Aug. 14, 2012, Annals of Internal Medicine, online


'/>"/>
Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Infection Might Raise Blood Clot Risk for Older Adults: Study
2. EKG Heart Test May Predict Risk in Older Adults
3. Callahan honored for improving older adults health in their doctors offices
4. Adding drug to standard chemotherapy provides no survival benefit for older lung cancer patients
5. Study examines drug regimen for the treatment of non-small cell lung cancer among older patients
6. Avastin No Benefit to Older Lung Cancer Patients: Study
7. Women With Older Partners More Often Admitted to Nursing Homes
8. Bridging the gap in treatment for older women with breast cancer
9. Taking Away Car Keys Can Be Tough for Older Drivers
10. Researchers determine vitamin D blood level for reducing major medical risks in older adults
11. National poll: Low cost, lifesaving services missing from most older patients health care
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Older Antipsychotics May Work as Well as Newer Ones: Review
(Date:10/13/2017)... ... October 13, 2017 , ... The International Association of Eating ... excellence for the field of eating disorders, announces the opening of early registration ... Orlando, Florida at the Omni Resort at ChampionsGate. , The annual ...
(Date:10/13/2017)... ... ... Apple Rehab Shelton Lakes , which specializes in the delivery of ... part of a disaster drill on October 3rd. , Apple Rehab participated with the ... as well as the Connecticut Long Term Care Mutual Aid Plan (LTC-MAP). The ...
(Date:10/13/2017)... , ... October 13, 2017 , ... Global Healthcare Management’s ... Alexandria Park in Milford, NJ. This free event, sponsored by Global Healthcare Management’s ... The fun run is geared towards children of all ages; it is a ...
(Date:10/13/2017)... ... October 13, 2017 , ... “The Journey: From the Mountains to ... to save lost souls in the Philippines. “The Journey: From the Mountains to the ... teacher of the Bible. She has taught all ages and currently teaches a class ...
(Date:10/12/2017)... New Orleans, LA (PRWEB) , ... October 12, 2017 , ... ... fitness centers in the U.S., announced today its plans to open a flagship location ... club will occupy the former Rooms To Go store next to Office Depot in ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... -- Diplomat Pharmacy, Inc. (NYSE: DPLO ) ... , and named its founder as Diplomat,s chief information ... Tennessee , will operate under Diplomat subsidiary Envoy ... for health care partners to include IT outsourcing, consulting, ... "In an interoperable world, technology delivers comprehensive insight and ...
(Date:9/28/2017)... 2017 Hill-Rom Holdings, Inc. (NYSE: HRC), will ... and webcast on Friday, November 3, 2017, beginning at ... at approximately 8:30 a.m. (CDT) / 9:30 a.m. (EDT). ... financial performance and guidance for 2018, Hill-Rom executives will ... operational performance, and long-range financial outlook through 2020. ...
(Date:9/25/2017)... , Sept. 25, 2017  EpiVax, Inc., ... vaccine design, and immune-engineering today announced the launch ... the development of personalized therapeutic cancer vaccines. EpiVax ... provided exclusive access to enabling technologies to the ... MBA will lead EpiVax Oncology as Chief Executive ...
Breaking Medicine Technology: