CATIE.......psych!

Incoming spin, incoming spin........here is your three minute warning!

Four of Big Pharmas PR departments will be burning the midnight oil tonight.

The long awaited CATIE study by the US federal National Institutes of Mental Health compared the effectiveness and side effects of atypical antipsychotics from Eli Lilly (Zyprexa), Pfizer (Geodon), Johnson & Johnson (Risperdal) and AstraZeneca (Seroquel) with the generic drug perphenazine. The study (to be published in the next NEJM) has found little difference in the drugs' performance on the mental illness.

"Surprisingly, the older, less expensive medication used in the study generally performed as well as the newer medications," the researchers said.

Perphenazine "was as well tolerated as the newer drugs and was equally effective as three of the newer medications," they added. "Contrary to expectations, movement side effects -- rigidity, stiff movements, tremor, and muscle restlessness -- primarily associated with the older medications, were not seen more frequently with perphenazine...than with the newer drugs."

"The study has vital public health implications because it provides doctors and patients with much-needed information comparing medication treatment options," said Dr. Thomas R. Insel, director of the National Institutes of Mental Health. "It is the largest, longest, and most comprehensive independent trial ever done to examine existing therapies for this disease."

The message Big Pharma wont want disseminated is that a 40-year-old generic schizophrenia drug is just as good as name-brand ones that cost 10 times as much.

So, what might be their spin options?

1. Rubbish the study (difficult given its prestiege and the, industry created, expectation)
2. Divide and conquer (our drug was better in this patient subset or with this endpoint)
3. Ignore the study (a tactic successfully used with the ALLHAT study in hypertension)

Let's see what they do...............................

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