New-Generation Drugs for Schizophrenia Popular With Doctors -- and Patients
Nov. 18, 1999 (Chicago) -- Psychiatrists have embraced the new, more effective, and less toxic schizophrenia treatments since they first came on the market a decade ago, according to a new study. However, the research, presented at the 127th Annual Meeting of the American Public Health Association, also indicates that the old-line drugs are still in widespread use.
Economist Tami Mark, PhD, of the MEDSTAT consulting group, surveyed about 250 psychiatrists around the country. Most of the physicians responded to the questionnaire, which looked into their prescribing practices during a two-year period.
"They have adopted the new generation of antipsychotics, probably [because of] their lower side effect profile," Mark tells WebMD. Starting in 1989, when clozapine became available, these new-generation antipsychotics have proven more effective against certain symptoms of schizophrenia -- such as withdrawal -- with fewer side effects. Most notably, the newer medications are less likely to cause symptoms associated with tardive dyskinesia -- a side effect characterized by involuntary facial tics and muscle spasms. There are now four of these newer antipsychotics on the market, including one called olanzapine that is also proving popular.
Still, says Mark, only a few doctors used one drug for more than 30% of their patients. "Patients need access to a variety of these antipsychotic drugs. There may not be a magic bullet for every patient. Physicians are not swarming to one particular drug," says Mark.
Mark also looked into the reasons physicians decided to make the switch to the newer drugs. "There seems to be a peer effect. If your peers are using it, you're more likely to use it. Sometimes economists calls this a herd effect," says Mark. She has yet to evaluate the effects of pharmaceutical advertising on the drugs' popularity.
On the negative side, the newer drugs can cost as much as 100 times more than their older counterparts. But Mark says it's not clear that insurance, or lack of it, has proved a barrier to the newer drugs' use. "There's some tentative evidence that insurance status may matter," however, she says.
Eli Lilly and Co., the manufacturer of olanzapine, financed the study.