Atypical Drugs Last Longer

New schizophrenia anti psychotics outperform first generation relapse

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) With advancements in pharmaceuticals happening every day, many people wonder what differences really exist in novel treatments. Doctors hold the same questions.

Within a recent study published in the journal Molecular Psychiatry, doctors and psychiatrists analyze the latest schizophrenia medications against previous antipsychiotics. The study focuses on relapse prevention, and although it found the new drugs more effective, its authors still recommend individualized treatment.

"Visit a mental health professional to determine the right treatment for you."

Taishiro Kishimoto, M.D., Ph.D., of the Zucker Hillside Hospital and his team compared the performance of second-generation antipsychotics (SGAs) against first-generation antipsychotics (FGAs) in an effort to determine relapse prevention efficacy.

The doctors sought to identify relapse, treatment failure, hospitalization, drop-out, and other intolerable activities in patients participating in trials lasting six months or more.

With twenty-three studies at hand, doctors determined the pooled relative risk using a random-effects model to determine both individual and group effectiveness of SGAs against FGAs. On an individual scale, no single SGA outperformed FGAs (primarily haloperidol) in relapse rates except in the case of risperidone when viewed short-term.

Viewing antipsychotics holistically, FGAs prevented relapse less often than SGAs, and atypical psychotics also outperformed FGAs in treatment failure and hospitalization. Although the results showed the relapse superiority to be modest over FGAs, the distinction was confirmed in double-blind trials, with patients of varying degrees, using actual and estimated relapse rates, and with multiple FGA dosages.

SGAs also known as atypical antipsychotics, differ in both form and function from FGAs. First-generation antipsychotics include chlorpromazine, thioridazine, and haloperidol and were made to primarily treat the "positive" signs of psychosis including hallucinations, delusions, and the actions following illusive thought.

Past studies shown SGAs to effectively treat negative symptoms of schizophrenia as well, which tend to be more personal including emotional numbness, social withdrawal, other restrictions in behavior and thought. Few controlled trials, however, compared atypical and typical antipsychotics for relapse prevention.

Dr. Kishimoto and his team explain that within their study, "there was no significant heterogeneity or publication bias. The relevance of the somewhat greater efficacy of SGAs over FGAs on several key outcomes depends on whether SGAs form a meaningful group and whether mid- or low-potency FGAs differ from haloperidol.

Regardless, treatment selection needs to be individualized considering patient- and medication-related factors." 

Everybody is different. To follow the advice of a doctor, speak with a mental health professional about the right treatment for schizophrenia.  

Reviewed by: 
Review Date: 
November 30, 2011
Last Updated:
November 30, 2011