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CATIE renews debate over old versus new antipsychotics: some experts warn against interpreting CATIE's findings as an endorsement of the typicals.

Article Excerpt
Some behavioral health leaders and government policymakers believe the first-phase results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) justify a look back at first-generation antipsychotics ("typicals") as viable first-line treatments for schizophrenia. Yet two experts interviewed by Behavioral Healthcare suggest that the initial results perhaps should have these individuals looking forward instead, toward a next class of drugs that could improve on the efficacy of currently used antipsychotics without the side effects that plagued compliance with the conventional drugs.

Rather than emphasizing that the conventional antipsychotic perphenazine (brand name: Trilafon) showed results comparable with those of four newer antipsychotics in CATIE, professionals should be concerned that 74% of patients who received at least one dose of one of the studied drugs discontinued treatment prematurely, says the chairman of the University of Maryland School of Medicine's psychiatry department.

"None of these drugs are home runs," says the university's Anthony F. Lehman, MD, MSPH. "If we had a treatment that was really great, more people would switch to it."

The much-anticipated double-blind study comparing perphenazine with the newer antipsychotics olanzapine (brand name: Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon) was published in the September 22, 2005,...

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