Newer antipsychotic drugs are no better than older ones, study finds

The results of this research are not supported, I believe, by a "real
world" test of validity.

As the previous responder pointed out, it is easy for a team of
mostly relatively young researchers who were perhaps not working when the
first generation antipsychotics (FGA) were universal, to carry out
detailed measures of quality of life and somehow miss the wood for the
trees. Before the advent of second generation antipsychotics (SGA), you
could instantly identify people with schizophrenia both in hospital and
the community, because they shook and shuffled their way around corridors
and the streets with Parkinsonian slowness, large abdomens, hunched
shoulders, and if they were unlucky, persistent irreversible involuntary
movements. You do not see this any more except in people who remain on
long term FGA treatments. It is a phenomenon which has thankfully largely
disappeared from rich societies whose healthcare systems can afford
routine treatment with SGA's.

Of course SGA's have their problems, with glucose metabolism
abnormalities, weight increase, prolactin disturbance etc, but I do not
believe that these are equal in significance to the irreversible poisoning
of the mesolimbic dopaminergic tracts caused by FGA's.

There may have been identifiable reasons for this research failing to
separate benefits from first and second generation antipsychotics, but I
would suggest two: the patient group was selected to be those with
problems with their existing treatment, who might be expected to include
people who were going to have problems with any treatment. The follow up
period was also too short to identify long term accreting problems of
tardive dyskynesia.

I hope that this paper will not be picked up by non-clinical health
funding professionals to promote a mass return to the FGA era.

Competing interests:
Received medical education sponsored by multiple pharmaceutical companies over many years.