[NYAPRS Enews] Reuters: Study May Prompt Rethink On Schizophrenia Drugs

[Matt Canuteson]

NYAPRS Note: The article below highlights a recent study that has found
that people with schizophrenia who were given lower cost 'old
generation' medications were less likely to die prematurely compared to
people on newer treatments despite the older products well-known adverse
side effects. 

These findings underscore the continued controversy over the safety of
medications for people with psychiatric disabilities, specifically 'new'
vs. 'old' generation medications. 

 

Study May Prompt Rethink On Schizophrenia Drugs

By Ben Hirschler  Reuters  July 13, 2009

 

* Fewer deaths with clozapine than newer drugs

* Call to consider cheap generic as first-line treatment

* Finnish study fuels debate on atypical antipsychotics

 

LONDON, July 13 (Reuters) - Schizophrenia patients given a cheap older
drug are less likely to die prematurely than people on newer treatments,
despite the older product's well-known adverse side effects, Finnish
researchers said on Monday.

 

The finding may lead to wider use of clozapine -- sold by Novartis as
Clozaril, but also available as a generic -- instead of newer drugs like
AstraZeneca's Seroquel, the current market leader.

 

Clozapine was the first of a new generation of schizophrenia drugs,
known as atypical antipsychotics. But its use has been restricted by
health authorities because of safety concerns and patients taking it
require regular blood tests.

 

Despite this, an analysis of 10 years' records for 67,000 patients in
Finland found that, compared to treatment with the first-generation drug
perphenazine, the risk of early death for patients on clozapine was
reduced by 26 percent.

 

By contrast, mortality risk was 41 percent higher for those on Seroquel,
known chemically as quetiapine; 34 percent higher with Johnson &
Johnson's Risperdal, or resperidone; and 13 percent higher with Eli
Lilly's Zyprexa, or olanzapine.

 

"We know that clozapine has the highest efficacy of all the
antipsychotics and it is now clear, after all, that it is not that risky
or dangerous a treatment," study leader Jari Tiihonen of the University
of Kuopio said in a telephone interview.

 

"We should consider whether clozapine should be used as a first-line
treatment option."

 

Thousands Of Premature Deaths

Tiihonen estimates clozapine is given to around one fifth of Finnish
schizophrenia patients, but less than 5 percent in the United States.

 

Clozapine's side effects include agranulocytosis, a potentially fatal
decline in white blood cells, and current rules stipulate the drug can
only be used after two unsuccessful trials with other antipsychotics.

 

Tiihonen and colleagues wrote in the Lancet medical journal that these
restrictions should be reassessed in the light of their findings, since
not using the drug may have caused thousands of premature deaths
worldwide.

 

Seroquel, Zyprexa and Risperdal are among the world's top-selling drugs,
with a combined sales of $12.5 billion in 2008, although Risperdal now
faces generic competition.

 

Worries about the safety profile of all the atypical antipyschotics have
loomed large since 2002, however, following evidence of increased rates
of diabetes and cardiovascular disease.

 

The Finnish study found no pronounced differences in heart deaths
between the different atypicals, but patients on clozapine had a
substantially lower risk of suicide while those on Seroquel were more
likely to kill themselves.

 

An AstraZeneca spokeswoman said the Anglo-Swedish company was
comfortable that Seroquel was safe, effective and an important treatment
for mental illness.

 

Schizophrenia is a severe psychiatric disorder in which patients
experience distorted thinking, hallucinations and abnormal emotions.
(Editing by Jon Loades-Carter) 

 

http://www.reuters.com/article/rbssHealthcareNews/idUSLA49330220090712?s
p=true

 

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