Study: Newer Antipsychotic Drugs Are Overused
Researchers Say Many Doctors Prescribe Drugs Despite Lack of Evidence of Effectiveness
Jan. 7, 2011 -- Many people taking powerful psychiatric medications that increase their risk of weight gain and diabetes are prescribed those drugs when there’s little evidence that they will get any benefit from them, a new study shows.
What’s more, experts say that even when these drugs, which are known as atypical antipsychotics, are prescribed as recommended, they may not be safer or more effective than the less expensive, older medications that they’ve apparently replaced.
“Atypical agents were once thought to be safer and possibly more effective,” says study researcher G. Caleb Alexander, MD, an assistant professor in the department of medicine at the University of Chicago Hospitals. “And what we’ve learned over time is that they are not safer, and in the settings where there’s the best scientific evidence, they are no more effective.”
How Drugs Developed for Schizophrenia Became Used as Antidepressants
The first generation of drugs to treat serious mental illnesses like schizophrenia were introduced in the late 1950s and 1960s, but those drugs often had disfiguring and painful neurologic side effects like muscle spasms and tremors and caused involuntary movements like facial grimacing.
In 1989, the first of a newer generation of atypical antipsychotic drugs, Clozaril, was introduced with the promise of being more effective than its predecessors, with fewer side effects. Other medications in the class soon followed, including Abilify, Geodon, Invega, Risperdal, Saphris, Seroquel, and Zyprexa.
“Since there were all these new drugs, and it costs 700 to 800 million to bring a drug to market, drug companies needed to make that money back,” says Jeffrey Lieberman, MD, chairman of the department of psychiatry at Columbia University, who was not involved in the study. “These drugs were marketed aggressively.”
The study, which was published online in the journal Pharmacoepidemiology and Drug Safety, documents what Lieberman and others believe were the effects of that marketing.
Researchers found that the number of office visits in which a doctor documented a patient’s use of atypical antipsychotics more than doubled since the mid-1990s -- climbing from 6.2 million in 1995 to 14.3 million by 2008, making them the top-selling pharmaceutical drug class.