April 12, 2006

Best Schizophrenia Drug? more CATIE 2 Study Results

Earlier this week we covered the release of the results from the CATIE 2 drug comparison study funded by the National Institute of Mental Health. Instead of focusing on how some symptom or side effect waxes and wanes, the government trial focused on the big picture: How do typical schizophrenia patients fare on the drugs over the long term?

The results were surprising: whatever the drug being tried, three-quarters of all patients stopped taking it, either because it did not make them better or had intolerable side effects. The discontinuation rates remained high when they were switched to a new drug, but patients stayed on clozapine about 11 months, compared with only three months for Seroquel, Risperdal or Zyprexa.

"Clozapine is better by far than the other antipsychotics," said Carol Tamminga, a psychiatry professor at the University of Texas Southwestern Medical Center at Dallas, who wrote an editorial in the American Journal of Psychiatry about the trial. "The question is: Why do doctors not use it?"

The drug requires more careful monitoring to prevent potentially fatal bone-marrow toxicity, she said, but a national monitoring program ensures it is used properly. Tamminga agreed that marketing may play a role in why the drug is not used more often.

"Clozapine is less marketed," she said. "It is off patent. Even when it was on patent, it has never been as actively marketed as the other drugs."

For More information: Schizophrenia Drug Gets Vote of Confidence

More Information:
Funding bias in clinical trials?
Schizophrenia Drugs Often Biased towards funding company

For more technical information see: Practical Treatment Information for Schizophrenia


Comments

my daughter's doctor has recommended clozaril. but we are afraid because of the side effects and also because my daughter does not take her medicine regularly and we cannot monitor if she takes her medication. her husband is also unable to follow her medication. under these circumstances we are not sure how to proceed. can you help?

Posted by: zarikhan at May 10, 2006 09:38 AM

Clozaril is the BEST DRUG.But it is cheaper but its cost is increased by the requirement about bloodtest for agronolcutides.My daughter is now taking 700mgs of clozaril for the past 4 years and as advised by doctor has stopped doing the bloodtest for the last oneyear.It is now required once a year only and this requirement about bloodtest is exaggerated by drug MNCs as it is far superior to other ATYPICALS. it is basically OFFPATENT and that is the main problem for this wonderful drug.
The drug MNCs who are based in GENEVA where WHO is also located have even ensured clozaril is not in the 354 essential drug list of WHO!!!!!!!!!!!!!!!!Please ask a psych doctor how many times he has to stop clozaril due to agronulcides?

Posted by: captainjohann at May 13, 2006 03:48 AM

My son is used Clozaril for 1 year at a dozage of 400 mg/per day The drug is very good except side effects. The worst effect ist the sleepness. My son is unable to get up early in the moorning. This affects the moorning leesons. Does anyone have any comment on that? Is there any other drug overcome this side effect?

Posted by: ─░lker at May 17, 2006 06:51 AM

My son has been on Clozaril since mid-March '06 is slowing improving. He gets sleepy too so the doctor also prescribed a "perky" pill. You may want to inquire his psch about this.

Posted by: DAISY at May 30, 2006 11:13 PM

I think that Clozaril(Leponex) it is more for acute phases for
hallucinations for exemple like sensation of hear voices in the head and some sensation of "telepaty" and for persons that
have antisocial conducts like agrissivity. this medicament have many side-effects even prejudicials
for health, i know because i already took this. Now
i take Risperdal daily, i feel
myself compensated and stabilized with very little
side-effects.

Posted by: Luis Pratas at May 31, 2006 05:20 PM

6/9/06

Many patients would not take the full dosage of the older prescibed antipsychotic drugs. The patients would split the pills to reduce, or avoid the bad side effects. CATIE should take this into account when leading us to believe taht the older antipsychotics were better. It maybe that the patients when at home never took the fully prescibed daily dose of medication.

Posted by: Ken1 at June 9, 2006 12:27 PM

I've been on Leponex for 2 years now, it has made me gain alot of weight and I am always tired. I took Leponex when I was pregnant with my second child but stopped when I was breast feeding as my little one was always sleeping and drowsy, then I got sick again and had to take the leponex again...my doctor has not told me about the side effects, I'm always tired and thirsty? What should I do? I feel as if I have no will to live?

Posted by: Gretel at March 6, 2007 12:15 AM

MY BROTHER USE OLANZAPINE BUT HE DONT USE THEM REGULARY.HE HAS PUT ABOUT 20 KG WEIGHT MORE.HE FILLED SPEEP ALL THE TIME BUT I AM NOT LOOKING ANY GOOD EFFECT.IS THERE ANY MEDICAMET THAT CURE FOREVER SCHIZOPHRENIA?

Posted by: TAULAND at January 14, 2008 03:42 AM

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