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Study questions benefits of costly schizophrenia drug

WEST HAVEN, Conn. - A study at 17 Veterans Affairs (VA) hospitals comparing an older, pennies-a-day schizophrenia drug with a newer, far more expensive one found little advantage to the high-ticket drug. The researchers, who report their findings in the November 26 issue of the Journal of the American Medical Association, say this is the first long-term, rigorously designed experimental study of the newer drug, which boasts U.S. sales of $2 billion annually.

The researchers compared haloperidol, one of an older class of schizophrenia drugs called typical antipsychotics, to olanzapine, the most expensive among the newer atypical antipsychotics. Used alone, the older medications are more likely to cause troubling side effects such as tremors and twitches. But the study had doctors prescribe haloperidol as they would ideally in actual practice-accompanied from the outset by another drug, benztropine, to minimize side effects.

"We gave the benztropine prophylactically along with the haloperidol, as is needed for a fair and clinically informative comparison," said lead author Robert Rosenheck, MD, director of VA's Northeast Program Evaluation Center in West Haven, Connecticut, and a professor of psychiatry and public health at Yale University Medical School.

"That's why we think this study is more relevant to everyday practice. We wanted to compare the two drugs in the way they are used in the real world."

The randomized, double-blinded study, which followed patients for one year, found no differences between the drugs in reducing schizophrenia symptoms or improving quality of life. As for side effects, olanzapine tended to cause weight gain. It resulted in slightly less akithesia, or restlessness, and somewhat better cognitive status, but not enough to improve patients' quality of life or overall functioning.

Though the drugs produced similar results overall, they come with a whopping difference in price: Olanzapine costs m
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Contact: Pamela Redmond
pamela.redmond@mail.va.gov
203-937-3824
VA Research Communications Service
25-Nov-2003


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