June 30, 2005

Equal Efficacy of Three Meds?

In one of the first studies of its kind, researchers from the University of North Carolina (in conjunction with AstraZeneca, a pharmaceutical company). report preliminary results from a comparison of three atypical antipsychotic drugs (quetiapine, olanzapine, risperidone) taken by first-episode psychosis patients. The study lasted 52 weeks, and involved patients at 26 U.S. sites.

The results? In terms of rate of discontinuation, efficacy outcome (measured by symptom rating scales), and side effects, all three drugs were rated equally. The most common side effects reported for all the medications were sleepiness and weight gain. Although this is interesting for consumers, it requires independent validation by a non-interested party before we can put too much weight on it. The information from this report is from a marketing/press release from the company.

A word of caution is always necessary when a pharmaceutical company is involved in any way with a medication study. Astrazeneca may be attempting to increase their standing on the national drug market by showing their product to be on par with giants like olanzapine and risperidone. This is, in fact, what the study shows...however, companies have a tendency to only make public their positive results.

Nevertheless, this data perhaps offers psychiatrists and consumers more options when they are exploring together what the best treatment is to control an individual case of schizophrenia. Given that everyone reacts differently to medication, results from studies like these that indicate equal control of symptoms from three medications might allow consumers to more freely switch to another type of prescription if they are experiencing negative side effects on their current one.

Because the population size of this study was so large, it is important to remember that many different experiences with these medications probably "averaged out" in the end to produce the results of equal efficacy. From an individual perspective, this does not necessarily mean that one medication is the same as another - it simply means that for the general population, there doesn't seem to be a clear leader among the three tested medications for the absolute best symptom control, despite what pharmaceutical companies might indicate with their advertising campaigns. The results also did not indicate how effective each medication was, only that they were equal in terms of efficacy and discontinuation rate.

The study also highlighted that dosing of these medications are highly individualized - "Results...show that the mean daily dose of certain antipsychotics differ by as much as 100% from when the treatment was introduced to the present time." This is consistent with the experiences of many consumers - often a medication dosage must be adjusted several times before an individual finds optimal symptom control with the fewest side effects.

The results from this comparison study were presented at the 8th World Congress of Biological Psychiatry (WCBP), in Vienna, Austria.

Source: Pharmalive (http://www.medadnews.com). See the full story at http://tinyurl.com/ayk7e

About AstraZeneca (http://www.astrazeneca.com/)

AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of prescription pharmaceuticals and the supply of healthcare services. It is one of the world's leading pharmaceutical companies with healthcare sales of over $21.4 billion and leading positions in sales of gastrointestinal, cardiovascular, respiratory, oncology and neuroscience products. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the FTSE4Good Index.


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