More Bad News on Antipsychotics and Schizophrenia

It amazes me how much data I continue to run into that supports the National Institute of Mental Health's contention that psych meds work about half the time. There is much anecdotal data, too, from clinicians and patients that support the same basic number. Even stronger scientific data came in September via the CATIE study, which showed even worse performance on the part of atypical antipsychotics with about 70 percent of patients ditching their initial antipsychtoic in favor of another because the first med either didn't work in treating symptoms or generated unacceptable side effects.

Now, from a health care data research company comes news that schizophrenics switch off the first med they take 70 percent of the time. There's slighly better news for some of the drugs schizophrenics take. Patients switch from Zyprexa, an atypical antipsychotic, 43 percent of the time. They ditch Risperdal, another atypical, 46 percent of the time. The data comes from sifting national data from schizophrenics in the private insurance system, which is to say patients who aren't in the Medicaid system and are, thus, less severely ill. The fact that the discontinuation rate--or more properly, the switching rate--lines up with results from the CATIE study is sobering. We don't have many options other than antipsychotics for medication-based treatment of schizophrenia. These meds are the only thing that can knock down hallucinations, for example, when they work well. Too bad they don't work all the time. There are no new classes of meds of the horizon. I pity these unlucky folks.

In short, this fresh data is further evidence that antipsychotics just don't work as well as they need to in patients who desperately need these meds to work for them. It's further evidence, too, that the NIMH was dead on with its assessment of half-performance of psych meds as a whole.

So why is there virtual silence in the media about how poorly psych meds perform? Why is there only the most perfunctory news accounts, for example, of the CATIE study and no examination of what spotty performance means in the lives of patients? (By the way, this is one place where I must actually praise the New York Times for poking away at this issue albeit in a piecemeal, "a new study says" way and usually only in regards to anti-depressants.) Where is the accountability? I won't even guess at the reasons for the time being.