BMJ 2000;321:1360-1361 ( 2 December )

Editorials

Atypical antipsychotics

Patients value the lower incidence of extrapyramidial side effects

Papers p 1371

The first 150 words of the full text of this article appear below.

An infectious optimism has infused the field of schizophrenia with the availability of the new "atypical" antipsychotics. However, an article by Geddes et al in this issue provides sobering evidence which questions this (p 1371).1 By pooling data from 52 controlled studies comparing atypical antipsychotics with the old typical antipsychotics in 12 000 patients, Geddes et al. failed to find any clinically significant evidence of superiority in efficacy, or for that matter tolerability, for atypical antipsychotics as a group, once the inappropriately high doses of the comparator were taken into account.

The results are even more sobering given the fact that most of these trials were conducted in patients who had already had a history of partial response to typical antipsychotics---thus having an inherent bias against the older typical antipsychotics. On the other hand, prescription data suggest that atypical antipsychotics account for nearly three out of four new prescriptions for . . . [Full text of this article]
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Relevant Articles

Atypical antipsychotics in the treatment of schizophrenia
Cliff Prior, Judi Clements, Michelle Rowett, David Taylor, Rhiannon Rowsell, Christopher Link, John Donoghue, Sing Lee, Ian Anderson, Richard Duggins, David Rhinds, William Hall, Robert Kerwin, Clive Adams, Lorna Duggan, John Geddes, Paul Harrison, Nick Freemantle, and Paul Bebbington
BMJ 2001 322: 924. [Extract] [Full Text]

Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis
John Geddes, Nick Freemantle, Paul Harrison, and Paul Bebbington
BMJ 2000 321: 1371-1376. [Abstract] [Full Text] [PDF]

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  • Sobell, J. L., Mikesell, M. J., McMurray, C. T. (2002). Genetics and Etiopathophysiology of Schizophrenia. Mayo Clin Proc. 77: 1068-1082 [Abstract]  
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  • (2001). Newer Antipsychotics: Good, But Not as Good as Touted. JWatch Psychiatry 2001: 11-11 [Full text]  
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