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Schizophrenia Drugs: Is Newer Better?

Study Shows New Drugs Have Similar Side Effects, but Expert Disagrees
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But another researcher says the newer schizophrenia drugs are more effective at preventing these Parkinson's-like nerve and muscle problems -- called extrapyramidal side effects. And they provide other advantages over older schizophrenia drugs such as Haldol and Thorazine in treating the disease, which affects about 2 million Americans. Symptoms of schizophrenia include hearing voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them.

"The newer drugs haven't blown the older drugs out of the water in terms of symptom control. However, they are more effective at preventing relapse, and patients seem more willing to stay on their treatment with them compared to the older drugs," says Jeffrey A. Lieberman, MD, director of the Mental Health Clinical Research Center at the University of North Carolina School of Medicine. "And the newer drugs are better at controlling symptoms such as depression."

In his own research comparing new and old schizophrenia drugs, including data presented at the 2000 annual meeting of the American College of Neuropsychopharmacology, Lieberman found that people diagnosed with their first episode of schizophrenia fare much better when treated with newer schizophrenia drugs than with older medications. And in treating his own patients, he says he finds the newer schizophrenia drugs to be more effective. "It could be that the numbers of the Lancet study indicate that there's little difference between both classes in preventing extrapyramidal side effects, but it's hard to believe, because we do see a difference," he tells WebMD.

Generally, he says, he prescribes the newer schizophrenia drugs to first-episode patients or those on older medications with a history of these movement problems. "But if people have done well on older medications and have not had intolerable side effects, there's usually no need to switch them."

However, previous studies indicate that about two in three people taking older schizophrenia drugs report these nerve and muscle side effects, and they are the primary reason for discontinuing treatment. One study presented at the European College of Neuropsychopharmacology's annual meeting in 1998 found nearly 90% of patients had these problems.

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