New schizophrenia drugs may be no more effective than conventional therapy

November 30, 2000

Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis

(Editorial) Atypical antipsychotics

There is no clear evidence that new antipsychotic drugs are any more effective or better tolerated than conventional drugs for patients with schizophrenia, despite being considered superior, finds a study in this week's BMJ. Conventional drugs should be considered first unless the patient has previously not responded to these drugs or has unacceptable side effects.

Geddes and colleagues analysed 52 trials, involving over 12,500 patients, comparing new or 'atypical' antipsychotics with conventional antipsychotics. They found that, when compared with conventional drugs at a moderate dose, atypical antipsychotics caused fewer side effects but had a similar effect on symptoms. All things being equal, conventional drugs should be used as the initial treatment of schizophrenia, although atypical drugs are a valuable addition to treatment options, especially when side effects are a problem, say the authors.

These findings emphasise the importance of a good relationship between doctor and patient, add the authors. The broader choice of drugs now available increases the chance of finding the most appropriate drug for each individual patient, encouraging the patient to adhere to their treatment, they conclude

John Geddes, Senior Clinical Research Fellow and Honorary Consultant Psychiatrist, Department of Psychiatry, Warneford Hospital, Oxford, UK


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