Wednesday, October 04, 2006

Atypical antipsychotics - psychiatrists " not duped, but beguiled"!

A study funded by the British government, has compared treatment results from a broad range of older antipsychotic drugs against results from newer "atypical antipsychotics".

The study was requested by Britain's National Health Service to determine whether the newer drugs ( which can cost 10 times as much as the older ones ) are worth the difference in price.

Guess what? They aren't!

Schizophrenia patients do as well, or perhaps even better, on older psychiatric drugs compared with newer and far costlier medications, according to a study published yesterday that overturns conventional wisdom about antipsychotic drugs, which cost the United States $10 billion a year.

The results are causing consternation. The researchers who conducted the trial were so certain they would find exactly the opposite that they went back to make sure the research data had not been recorded backward.

The study, published in the Archives of General Psychiatry, is likely to add to a growing debate about prescribing patterns of antipsychotic drugs. A U.S. government study last year called CATIE found that one of the older drugs did as well as newer ones.

Yesterday, in an editorial accompanying the British study, the lead researcher in the U.S. trial asked how an entire medical field could have been misled into thinking that the expensive drugs, such as Zyprexa, Risperdal and Seroquel, were much better.

"The claims of superiority for the [newer drugs] were greatly exaggerated," wrote Columbia University psychiatrist Jeffrey Lieberman. "This may have been encouraged by an overly expectant community of clinicians and patients eager to believe in the power of new medications. At the same time, the aggressive marketing of these drugs may have contributed to this enhanced perception of their effectiveness in the absence of empirical information."

Peter Jones, a psychiatrist at the University of Cambridge in England who led the study, searched yesterday for the right word to describe what had happened to his colleagues.

" 'Duped' is not right," he said. "We were beguiled."

More at the WaPo.

4 comments:

Anonymous said...

I am not sure that clinicians have been beguiled. More browbeaten. Given the relentless investment from the industry to support 'new generation' atypicals, it is small wonder that prescribing practices change. This trial will be challenged and questioned by commercially driven organisations (self selected populations, not robust data, not representative of current clinical practice etc) who will continue to drive clinical practice with selective use available data. It is still too one sided

More regulation is needed.

CL Psych said...

I agree wholeheartedly with the previous post. Rather than take up a lot of space here, I'll just refer interested readers to my blog post where I have discussed the latest study in detail.

Newer AP Meds Disappoint Again

I'd also like to relay a personal anecdote... at a hospital where I was attending a "medical education" session (an infomercial for Abilify), the hospital medical director stood up in front of the audience and added that these medications cost $800 million dollars each to develop and we should be uber-thankful for the drug companies' tireless efforts, etc. $800 million, eh? Many people in high places genuinely believe the hype. Good thing Goozner pretty much debunked the allegedly ludicrously high costs of developing meds (as did Public Citizen, I think) in his book The $800 Million Pill.

Anonymous said...

On that theme, note that Abilify did not feature in either CATIE or CutLASS. I bet you anything you like that our friends, the Abilfy sales folks, will try to make something out of that dubious link

Anonymous said...

check out the interview with Peter Jones at http://www.psychresearchupdate.com/
about his research on 1st vs. 2nd generation antipsychotics.