Gillian Maguire's List: TAMING THE MEDICATION TIGER

• In an accompanying editorial, two British researchers went further, calling the notion that newer agents are more effective or safer than older drugs "spurious." 

   

  "As a group they are no more efficacious, do not improve specific symptoms, have no clearly different side-effect profiles than the first-generation antipsychotics, and are less cost effective," wrote Peter Tyrer, M.D., of Imperial College London, and Tim Kendall, M.D., Ph.D., of the National Collaborating Centre for Mental Health in London.
• They did find that four second-generation agents were significantly more effective than older drugs. They were clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), and amisulpride (Solian, not approved in the U.S.).

• More than half the studies they did include had a different type of bias, Drs. Tyrer and Kendall said -- they used haloperidol as the comparator. 

   

  Haloperidol has a high rate of extrapyramidal effects compared with other first-generation drugs. 

   

  The result, they suggested, was to make the newer drugs' side effect profile look better than if other comparators had been tested instead.

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