Newer Antipsychotics No Better in Kids
Older Drug Works as Well as New Drugs, and Without the Weight Gain, Study Shows
WebMD News Archive
Zyprexa Manufacturer Responds continued...
The second-generation drugs were developed in large part to avoid these side
effects, which can include tics, rigidity, and even an irreversible,
Parkinson's-like syndrome that can be crippling.
Jamaison Schuler of Eli Lilly tells WebMD that the eight-week treatment arm
of the study was far too short to assess the risk for the well established,
long-term side effects.
"Physicians balance such potentially disabling and irreversible movement
disorders associated with many first-generation antipsychotics with the
potential metabolic adverse events associated with the second-generation drugs
when considering what therapy is best for each patient," he says.
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
The study is published online in the latest issue of the American Journal
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
"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.