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
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.
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
"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.