Are New Antipsychotic Medications More Effective?
> 1/4/2007 10:45:24 AM

In the ongoing search for the most effective chemical respones to crippling mental illness, pharmaceutical companies and the patients to whom they advertise usually choose the newer-is-better route. Surprising studies, along with thousands of individual cases across this country and the world, have begun to refute the reliability of that method, particularly as it applies to drugs designed to treat extreme psychoses.

Patients who find their courses of treatment unsatisfactory will naturally watch for developments in the field in the hope that newer medications may alleviate their symptoms more completely. Another hope is that advanced research can help downplay the often significant side effects of such drugs. Extrapyramidal symptoms, which can include physical tics and changes in cardiovascular functions, have long been a concern for patients suffering from varied psychoses, and some of the newer drugs such as Zyprexa aim to minimize these, but other potentially dangerous side effects come with the new meds, and some patients and their loved ones wonder if the companies responsible for creating and distributing these drugs considerably downplay their negative side-effects.

British researchers at the University of Cambridge, in a study published in January's Psychiatric Times, were very surprised to find that, in parallel yearlong prescription trials, new second-generation antipsychotics such as Zyprexa were ultimately not more effective than their first generation counterparts (Thorazine, Fluanxol, etc.) Using standard quality-of-life scale measurements (QLS), the researchers determined that, contrary to their hypothesis that SGAs would be superior:

Participants in the FGA arm tended to have greater improvements in QLS and symptom measures than those in the SGA arm, suggesting that the failure to find an advantage for SGAs was not due to the sample simply being too small.

These findings may result in major changes in the treatment of conditions like schizophrenia and bipolar disorder. Thousands of current lawsuits allege that SGAs cause or contribute to significant weight gain, diabetes, heart disease and possibly death in heavily medicated patients. While pharmaceutical interests have acknowledged the weight issue and touched on other concerns, they look to minimize the damage to their financial standing and public image while facing state and federal investigations into the marketing of particular medications.

Judging the merit of these complaints is often difficult as psychotic patients are already more likely to develop such physical ailments, especially when combined with behaviors like smoking, drinking or maintaining sedentary lifestyles. And there is no question that second generation drugs work very well for many patients. Still, the possibility that these medications have not been properly developed or are currently prescribed incorrectly is enough to warrant further investigation. In the meantime, those suffering from psychosis will continue to search for the most individually effective combinations of medicine, social and physical activity and therapeutic support.

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