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Newer Antipsychotics No Better in Kids

Older Drug Works as Well as New Drugs, and Without the Weight Gain, Study Shows

Zyprexa Manufacturer Responds continued...

The patients in the study who took the first-generation drug also took another drug used to reduce these movement-related side effects, which is a common treatment practice.

The study included 116 children and teens aged 8-19 who had been diagnosed with early-onset schizophrenia spectrum disorder (EOSS).

After eight weeks of treatment, 50% of the study participants taking molindone showed improvement in schizophrenia symptoms, compared to 46% of patients taking risperidone and 34% of patients on Zyprexa. There were no statistically significant differences among the improvements seen in the three different groups.

The study is published online in the latest issue of the American Journal of Psychiatry.

Although schizophrenia is not commonly found in children under 12, the Department of Health & Human Services estimates it occurs in about three out of every 1,000 adolescents.

Newer Antispychotics vs. Older Antispychotics

NIMH chief of child psychiatry Judith Rapoport, MD, agrees that the study was too small and the treatment arm too short to capture the full side effect profile of the older-generation drugs.

But she adds that periodically taking patients off molindone and other older antipsychotic treatments can help mitigate the risk for permanent side effects.

"The pendulum has probably swung too far in the direction of the newer generation of drugs," Rapoport tells WebMD. "There are probably children who would be better off taking a low-dose of a first-generation drug instead of a second-generation drug, especially if they gain a lot of weight on these newer drugs."

NIMH director Thomas Insel, MD, tells WebMD that the new study and the earlier trial in adults illustrate the need for better antipsychotic drugs.

At best, only half of the patients in the study responded to the medication they were on. And just 10% to 20% of the patients continued treatment for a full year.

"We really need a new era of drug development for psychotic illness, both in children and adults," Insel says. "These studies remind us that we are not where we want to be in the treatment of psychosis. There are just too many people who aren't getting better."

Teva Pharmaceuticals, the maker of generic risperidone, was contacted but WebMD did not receive comment by publication time.

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