Featured Research

from universities, journals, and other organizations

NIMH Study To Guide Treatment Choices For Schizophrenia

September 20, 2005
NIH/National Institute of Mental Health
A large study for the first time provides detailed information comparing the effectiveness and side effects of five medications -- both new and older medications -- that are currently used to treat people with schizophrenia. Overall, the medications were comparably effective but were associated with high rates of discontinuation due to intolerable side effects or failure to adequately control symptoms. Surprisingly, the older, less expensive medication generally performed as well as the newer medications.

Related Articles

"The study has vital public healthimplications because it provides doctors and patients with much-neededinformation comparing medication treatment options," said NIMH DirectorThomas R. Insel, M.D. "It is the largest, longest, and mostcomprehensive independent trial ever done to examine existing therapiesfor this disease."

Schizophrenia, which affects 3.2 millionAmericans, is a chronic, recurrent mental illness, characterized byhallucinations, delusions, and disordered thinking. The medicationsused to treat the disorder are called antipsychotics. Previous studieshave demonstrated that taking antipsychotic medication is far moreeffective than taking no medicine, and that taking it consistently isessential to the long-term treatment of this severe, disablingdisorder. Although the medications alone are not sufficient to cure thedisease, they are necessary to manage it.

In the CATIE (ClinicalAntipsychotic Trials of Intervention Effectiveness) trial, researchersdirectly compared an older medication (perphenazine), available sincethe 1950s, to four newer medications (olanzapine, quetiapine,risperidone, and ziprasidone), introduced in the 1990s. The purpose ofthe study was to learn whether there are differences among the newermedications and whether the newer medications hold significantadvantages over the older medications; these newer medications known asatypical antipsychotics, cost roughly 10 times as much as the oldermedications.

The size and scope of the trial, with more than1,400 participants at 57 sites around the country, its 18-monthduration, and its inclusion of a wide range of patients in a variety oftreatment settings ensure that the findings are reliable and relevantto the 3.2 million Americans suffering from schizophrenia.

At thebeginning of the study, patients were randomly assigned to receive oneof the five medications. Almost three quarters of patients switchedfrom their first medication to a different medication. The patientsstarted on olanzapine were less likely to be hospitalized for apsychotic relapse and tended to stay on the medication longer thanpatients taking other medications. However, patients on olanzapine alsoexperienced substantially more weight gain and metabolic changesassociated with an increased risk of diabetes than those studyparticipants taking the other drugs.

Contrary to expectations,movement side effects (rigidity, stiff movements, tremor, and musclerestlessness) primarily associated with the older medications, were notseen more frequently with perphenazine (the drug used to represent theclass of older medications) than with the newer drugs. The oldermedication was as well tolerated as the newer drugs and was equallyeffective as three of the newer medications. The advantages ofolanzapine — in symptom reduction and duration of treatment — over theolder medication were modest and must be weighed against the increasedside effects of olanzapine.

Thus, taken as a whole, the newermedications have no substantial advantage over the older medicationused in this study. An important issue still to be considered isindividual differences in patient response to these drugs.

Severalfactors, such as adequacy of symptom relief, tolerability of sideeffects, and treatment cost influence a person's willingness andability to stay on medication.

"There is considerable variationin the therapeutic and side effects of antipsychotic medications.Doctors and patients must carefully evaluate the tradeoffs betweenefficacy and side effects in choosing an appropriate medication. Whatworks for one person may not work for another," said Jeffrey Lieberman,M.D., CATIE's Principal Investigator and Chair of The Department ofPsychiatry, Columbia University and Director of the New York StatePsychiatric Institute.

The CATIE study was led by Lieberman, andco-Principal Investigators Scott Stroup, M.D. (University of NorthCarolina at Chapel Hill), and Joseph McEvoy, M.D. (Duke University).CATIE was carried out by researchers at 57 sites across the country,including private and public mental health clinics, Veteran's HealthAdministration Medical Centers, and University Medical Centers, wherepeople with schizophrenia received their usual care.

This NewEngland Journal of Medicine article is the first to report outcomesfrom the CATIE schizophrenia trial, and addresses many of the primaryquestions from the study. Future reports will address a multitude oftopics (e.g., cost-effectiveness of the medications, quality of life,predictors of response) and will provide a more detailed picture of theinteraction between patient characteristics, medication, and outcomes.The information from the CATIE study will inform new approaches forimproving outcomes in schizophrenia.

CATIE is part of an overallNIMH effort to conduct "practical" clinical trials that address publichealth issues important to those persons affected by major mentalillnesses in real world settings.

Story Source:

The above story is based on materials provided by NIH/National Institute of Mental Health. Note: Materials may be edited for content and length.

Cite This Page:

NIH/National Institute of Mental Health. "NIMH Study To Guide Treatment Choices For Schizophrenia." ScienceDaily. ScienceDaily, 20 September 2005. <www.sciencedaily.com/releases/2005/09/050920074954.htm>.
NIH/National Institute of Mental Health. (2005, September 20). NIMH Study To Guide Treatment Choices For Schizophrenia. ScienceDaily. Retrieved April 25, 2015 from www.sciencedaily.com/releases/2005/09/050920074954.htm
NIH/National Institute of Mental Health. "NIMH Study To Guide Treatment Choices For Schizophrenia." ScienceDaily. www.sciencedaily.com/releases/2005/09/050920074954.htm (accessed April 25, 2015).

Share This

More From ScienceDaily

More Mind & Brain News

Saturday, April 25, 2015

Featured Research

from universities, journals, and other organizations

Featured Videos

from AP, Reuters, AFP, and other news services

Judge OKs 65-Year Deal Over NFL Concussions

Judge OKs 65-Year Deal Over NFL Concussions

AP (Apr. 23, 2015) A judge has approved a potential $1 billion plan to resolve thousands of NFL concussion lawsuits filed by retired players. The NFL expects 6,000 of nearly 20,000 retired players to suffer from Alzheimer&apos;s disease or moderate dementia someday.(April 23) Video provided by AP
Powered by NewsLook.com
Research Says Complex Tools Might Not Be 'Our Thing' Anymore

Research Says Complex Tools Might Not Be 'Our Thing' Anymore

Newsy (Apr. 21, 2015) The use of complex tools has often been seen as a defining characteristic of humanity, but that notion is now in question. Video provided by Newsy
Powered by NewsLook.com
Our Love Of Puppy Dog Eyes Explained By Science

Our Love Of Puppy Dog Eyes Explained By Science

Newsy (Apr. 17, 2015) Researchers found a spike in oxytocin occurs in both humans and dogs when they gaze into each other&apos;s eyes. Video provided by Newsy
Powered by NewsLook.com
Scientists Find Link Between Gestational Diabetes And Autism

Scientists Find Link Between Gestational Diabetes And Autism

Newsy (Apr. 17, 2015) Researchers who analyzed data from over 300,000 kids and their mothers say they&apos;ve found a link between gestational diabetes and autism. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.


Breaking News:

Strange & Offbeat Stories

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News


Free Subscriptions

Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile

Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?

Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins