More Unimpressive Results for Atypical Antipsychotics

The Journal of Clinical Psychiatry (October 2006) has an article comparing haloperidol (Haldol), risperidone (Risperdal), and olanzapine (Zyprexa) in treating first-episode psychosis. This is a great design because patients were medication-naïve – they had not taken antipsychotic meds before.

The results: On all outcome measures, there was no significant difference between medications. They were equally effective. For side effects, haloperidol caused more extrapyramidal side effects and both risperdal and olanzapine caused more weight gain (especially olanzapine). Again, patients on the vastly more expensive second generation antipsychotics essentially fare no better than patients on the older medication. Don’t take this as a ringing endorsement of older meds – medications that cause heinous extrapyramidal side effects among a host of other unpleasant effects are certainly a mixed blessing.

I’ve posted extensively about second generation antipsychotics. Feel free to read about them here, here, here, here and here.