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 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 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.