New Schizophrenia drugs no better.

I thought it was already generally accepted that the atypicals weren’t necessarily more effective, just that they had less side-effects? (personally I’d say “different” rather than “less”, but that could certainly explain why the compliance rates were better with the atypicals in that study)

As regarding that “myth of antipsychotics” article, as I pointed out at the time, the author had completely misrepresented his sources.

I think we have to consider what else has changed since the atypicals were introduced 10 years ago that might enhance compliance - or rather, concordance, as the fashionable terminology would have it. I suspect that better monitoring has a lot to do with it, as well as new forms of care delivery in the community such as assertive outreach and home treatment. I don’t think there’s anything about the drugs themselves that improve compliance/concordance as in so many ways, they seem even more vile than their predecessors. Not only can they make you akathisic, they can also turn you into a diabetic, incontinent, hypertensive, hyperlipidaemic, impotent bubble-man. Nice!

What Zarathustra said.

“Although the newer drugs were not found to be any more effective in treating psychotic symptoms the compliance rate was significantly better.”
Didn’t we already know this?

The drugs don’t work better, they just generate fewer and different side effects, no?

beakie: you can’t forget that they actually are more tolerable for some people, though. My mother, for example, has horrible dystonic reactions with most of the typicals, and says she feels like a zombie the whole time- whereas with Magic Weight Increasing Drug, she feels lovely- her blood pressure has even come down (less anxious), she’s put on a rather sedate 7kg (good since she was 10kg underweight) and she’s much nicer to be around.

ETA: this has been true of me and my sister also, although we both seem to gain more weight. Except aripiprazole, which made me lose 20kg in 10 weeks from akathisia and Parkinsonism (I felt like I had a horrendous panic attack for about 3 months straight, and I couldn’t chew or swallow properly).

I’m glad you, your sis and your mum are feeling better!

I have no doubt that some people find the newer drugs more tolerable. But I remember the days when the atypicals were being touted round the wards and so convincing were the reps in their sales pitch, we actually believed that there could be NO extra-pyramidal side effects from these meds. So when patients were presenting with a case of the shakes from Risperidone, we were suspicious that they were just after some extra procyclidine.

By the time patients had started to display weight gain and diabetes, we were much more cynical.

The drug companies lie, and the more money is to be made, the more they lie. The truth is somewhere between what the drug reps say, and the people who claim there is no benefit to be had through the availablility of atypical antipsychotics.

I was lucky not to get EPSEs with risperidone, probably because I was taking a very low dose. I did start to lactate though, which was hilarious when manic.

basic rule of thumb, the atypicals seem better re side effects but are far from free of them. The old school typicals cause more side effects but work quicker with the acutely psychotic. In my experience this can cause its own problems with young first episode psychotics remaining ill for longer. No antipsychotic suits everyone either in effect and/or side effect. And yes those drug reps lie and lie, but then a system that relies on the drug companies to provide all the evidence will always be open to manipulation.