Featured Research

from universities, journals, and other organizations

Older Medication May Be More Cost-effective For Some Patients With Schizophrenia

Date:
December 1, 2006
Source:
NIH/National Institute of Mental Health
Summary:
A new study analyzing the economic implications of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) concludes that the older (first generation) antipsychotic medication perphenazine was less expensive and no less effective than the newer (second generation) medications used in the trial during initial treatment, suggesting that older antipsychotics still have a role in treating schizophrenia.

A new study analyzing the economic implications of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) concludes that the older (first generation) antipsychotic medication perphenazine was less expensive and no less effective than the newer (second generation) medications used in the trial during initial treatment, suggesting that older antipsychotics still have a role in treating schizophrenia. The study, published in the American Journal of Psychiatry on December 1, 2006, was funded by the National Institutes of Health's National Institute of Mental Health (NIMH).

The $42.6 million CATIE trial aimed to help doctors and the 2.4 million Americans who suffer from chronic schizophrenia tailor treatments to individual needs. It is the first study to directly compare several second generation antipsychotic medications and a representative first generation antipsychotic medication.

"The results from CATIE should encourage doctors to reconsider the use of perphenazine as another choice for patients with schizophrenia," said NIMH Director Thomas Insel, M.D.

More than 90 percent of antipsychotic prescriptions are written for second generation medications, despite the fact they are more expensive than the first generation agents used to treat schizophrenia. The majority of clinicians have traditionally believed that the newer antipsychotics are more effective and better tolerated than older agents, and many experts argued that these advantages justified the difference in cost.

Robert Rosenheck, M.D., of Yale University, and colleagues analyzed costs and quality-of-life factors associated with each of the five medications used in Phase 1 of the CATIE trial--olanzapine, quietapine, risperidone, ziprasidone, and perphenazine. They found that total monthly health costs, a figure that includes both average medication costs and inpatient and outpatient costs, were up to 30 percent lower for those taking the perphenazine than for those taking the second generation medications. In addition, the researchers found no statistically significant difference in overall effectiveness between perphenazine and the second generation antipsychotics, with regard to symptom relief and side effect burden.

The findings echo what was implied in the results of the first phase of CATIE, expanding the treatment options for patients with schizophrenia. It casts doubt on the notion that the second generation antipsychotics are better than the first generation antipsychotics, and suggests that perphenazine and other first generation antipsychotics may be just as beneficial for some patients.

Still, several conditions of CATIE limit any firm conclusions about perphenazine's perceived advantages. Not all patients respond the same to different medications. In addition, the study lasted 18 months--long enough to determine how patients respond to and initially tolerate the drugs, but not long enough to consider some serious long-term side effects, such as development of the movement disorder tardive dyskinesia (TD), diabetes, cardiovascular problems, or other medical conditions that can develop even years after a patient with chronic schizophrenia starts taking an antipsychotic medication. Despite these caveats, the study results suggest new ways of thinking about medication treatments for schizophrenia.

"These results encourage doctors to revisit the older medication as an alternative, especially if a treatment change is warranted," said Dr. Rosenheck. "By showing that perphenazine and possibly other older antipsychotics may be on equal footing with the second generation antipsychotics, CATIE has opened the door to more choice in treatment options."

The National Institute of Mental Health (NIMH) mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More information is available at the NIMH website, http://www.nimh.nih.gov.

The National Institutes of Health (NIH) - The Nation's Medical Research Agency - includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

Rosenheck RA, Leslie DL, Sindelar J, Miller EA, Lin H, Stroup TS, McEvoy J, Davis S, Keefe R, Swartz M, Perkins D, Hsiao JK, Lieberman J. Cost-effectiveness of Second Generation Antipsychotics and Perphenazine in a Randomized Trial of Treatment for Chronic Schizophrenia. American Journal of Psychiatry. 2006 Dec;163 (12): 2080-89.


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. "Older Medication May Be More Cost-effective For Some Patients With Schizophrenia." ScienceDaily. ScienceDaily, 1 December 2006. <www.sciencedaily.com/releases/2006/12/061201105955.htm>.
NIH/National Institute of Mental Health. (2006, December 1). Older Medication May Be More Cost-effective For Some Patients With Schizophrenia. ScienceDaily. Retrieved April 17, 2014 from www.sciencedaily.com/releases/2006/12/061201105955.htm
NIH/National Institute of Mental Health. "Older Medication May Be More Cost-effective For Some Patients With Schizophrenia." ScienceDaily. www.sciencedaily.com/releases/2006/12/061201105955.htm (accessed April 17, 2014).

Share This



More Mind & Brain News

Thursday, April 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Are School Dress Codes Too Strict?

Are School Dress Codes Too Strict?

AP (Apr. 16, 2014) Pushing the limits on style and self-expression is a rite of passage for teens and even younger kids. How far should schools go with their dress codes? The courts have sided with schools in an era when school safety is paramount. (April 16) Video provided by AP
Powered by NewsLook.com
Could Even Casual Marijuana Use Alter Your Brain?

Could Even Casual Marijuana Use Alter Your Brain?

Newsy (Apr. 16, 2014) A new study conducted by researchers at Northwestern and Harvard suggests even casual marijuana use can alter your brain. Video provided by Newsy
Powered by NewsLook.com
Couples Who Sleep Less Than An Inch Apart Might Be Happiest

Couples Who Sleep Less Than An Inch Apart Might Be Happiest

Newsy (Apr. 16, 2014) A new study by British researchers suggests couples' sleeping positions might reflect their happiness. Video provided by Newsy
Powered by NewsLook.com
Cognitive Function: Is It All Downhill From Age 24?

Cognitive Function: Is It All Downhill From Age 24?

Newsy (Apr. 15, 2014) A new study out of Canada says cognitive motor performance begins deteriorating around age 24. 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.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

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