Harvard Mental Health Letter

A comparison of antipsychotic drugs

The first phase of a large clinical trial sponsored by the National Institute of Mental Health has come to the surprising conclusion that the new generation of antipsychotic drugs introduced after 1985 is not more effective or safer than older, less expensive drugs.

The second-generation or atypical drugs constitute 90% of the market in 2005. It's believed that patients are less likely to stop taking these drugs because of evidence that they have fewer and less serious side effects, especially those involving muscle movements (rigidity, tremors, compulsive restlessness). It's also thought that the new drugs are more likely to improve the judgment, initiative, and responsiveness of schizophrenic patients.

The study, called the Clinical Antipsychotic Trials of Intervention Effectiveness, compared the older drug perphenazine with the newer medications olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon). Nearly 1,500 patients with chronic schizophrenia were divided into five groups; each group was given one of the drugs and all were followed for as long as 18 months.

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