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New Antipsychotics Drugs Aren't Created Equal

Patients Who Do Poorly on One May Show Improvement on Another

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In the study, patients were switched to Geodon from either conventional antipsychotics like Haldol or the atypical antipsychotics Zyprexa or Risperdal. All three groups reported improvements in verbal memory and verbal fluency, and many patients switched from conventional drugs also saw improvements in attention and mental function.

In a memory test involving delayed recall, patients switched to Geodon saw improvements of 16%, 19%, and 21% over their performances while on conventional antipsychotics Zyprexa and Risperdal, respectively.

Cost Is an Issue

One of the most troubling side effects of the older class of antipsychotic drugs is the frequent development of movement disorders such as muscle rigidity, tremors, and jitteriness. The newer drugs are believed to minimize these side effects. But new research suggests that low doses of the older drug Haldol may be almost as effective as the newer drugs with few side effects.

The older drugs still have a place in the treatment of schizophrenia, says psychiatrist and antipsychotic drug researcher David Garver, MD, because they cost far less than the newer drugs -- as much as 100 times less than some of them.

"Any mental health system that is trying to survive on a limited budget has a real incentive to use the older drugs," the University of Louisville professor of psychiatry tells WebMD. "In general, they have probably been used in this country in doses that were too high in the past. Recent studies suggest that patients do almost as well on low doses of Haldol as on the newer atypicals."

Haldol is also one of the only antipsychotic medications that can be delivered by injection. This is important because compliance with daily oral medication is very poor among schizophrenic patients. It is estimated that three out of four patients frequently skip doses, which can lead to worsening of symptoms.

"It is a rare schizophrenic patient who will take all of his or her medication," Garver says. "We are recognizing more and more that compliance is a major problem with treatment."

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