New Antipsychotics No Better Than First Generation
> 9/16/2008 5:01:59 PM

The supposedly new and improved or “atypical” variations on popular antipsychotic drugs carried the weight of great expectations when they debuted in the 1990s. Unfortunately, a large-scale study focusing on schizophrenic adolescents and sponsored by the National Institute of Mental Health finds that the medications in this most recent line are actually no more effective than the drugs they were designed to replace. New antipsychotics like Zyprexa and Risperdal have been touted as near-revolutionary pharmaceutical approaches to conditions that can, in their most severe forms, render their victims all but unable to function in the standard capacity. Their developers once claimed that they were ultimately more effective than far older drugs like molindone (Moban) and haloperidol, but that does not now appear to be the case. 

The study, performed at the University of North Carolina’s School of Medicine and over a four year period, tested the different drug strains on more than 100 individuals aged 8 to 19 who’d been diagnosed with early-onset schizophrenic spectrum disorders. Noting symptomatic changes and related side-effects over 8-week periods, researchers found that the atypical drugs were no more effective at relieving symptoms and that some of their most dangerous side-effects were actually more severe. 

The most significant of these effects is extreme weight gain. More than 90% of patients using atypical antipsychotics such as Zyprexa report consistent periods of weight gain that can increase one’s body mass by as much as 50% in a matter of months. The problem was so prevalent in this study that UNC researchers stopped recruiting subjects for the Zyprexa group for fear of causing long-term health problems. The equation is very simple, with appetite-inducing enzymes and blood glucose levels rising as more serious conditions requiring higher doses lead to even greater weight gain due to fat deposits caused by the presence of excessive sugar in the blood. 

Major health problems stem from this rapid change in body mass. Diabetes, high blood pressure and heart disease are but three of the deadly and inevitable products of obesity, especially given the tendency toward sedentary lifestyles and addictive behaviors displayed by so many schizophrenic individuals. Smoking rates, for example, are far higher among the affected population, and some researchers assert that the so-called calming effects of tobacco reduce the cognitive dysfunction common to all schizophrenic individuals. Unfortunately, such habits only complicate the pre-existing risks posed by both the condition itself and the medicines used to treat it. 

So the atypical drugs do not, in fact, counteract weight gain at all. All antipsychotics have been known to lead to increased body mass over time, but study subjects who switched from Zyprexa to Molindone gained weight at considerably reduced rates. The new drugs do, however, present milder versions of some of the first generation’s less serious side-effects including restlessness, muscle cramps and involuntary contortions. For the parents of schizophrenic children, especially those unreceptive to most related drugs, this news will surely come as a disappointment as each new generation of antipsychotics promises to be more effective than the last. The new drugs will continue to be marketed as better medicines, but this study establishes the fact that most schizophrenic or schizoaffective children and adolescents should initially receive the earlier drugs as a first line of defense. The keys to schizophrenia treatment, say the current study’s authors, are early diagnosis and the development of more effective medications. The fact that new generation drugs just don’t deliver on their claims only makes ongoing pharmaceutical research that much more important.



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