Atypical Anitpsychotics Disappoint A-G-A-I-N

McCue, Waheed, Urcuyo, Orendain, Joseph, Charles, and Hasan just published a study in the British Journal of Psychiatry suggesting that haloperidol (Haldol) may be more effective than some of the newer, dramatically more pricey antipsychotic meds. Link to abstract on journal's site here or just read below...

Background There is little information on the comparative effectiveness of second-generation antipsychotic agents.

Aims To determine if any of five second-generation antipsychotics or haloperidolis more effective in treating acutely ill patients with schizophrenia, schizoaffective disorder or schizophreniform disorder.

Method A sample of 327 newly admitted patients were randomised to open-label treatment with aripiprazole, haloperidol, olanzapine, quetiapine, risperidone or ziprasidone for a minimum of 3 weeks. Measures of effectiveness were improvement in mental status so that the patient no longer required acute in-patient care, and changes in Brief Psychiatric Rating Scale (BPRS) scores.

Results By the first measure, haloperidol (89%), olanzapine (92%) and risperidone (88%) were significantly more effective than aripiprazole (64%), quetiapine (64%) and ziprasidone (64%). Changes in BPRS ratings were not significant among treatments.

Conclusions Haloperidol, olanzapine and risperidone are superior to aripiprazole, quetiapine and ziprasidone for the acute treatment of psychosis in hospitalised patients with schizophrenia, schizoaffective disorder or schizophreniform disorder.

My View: At worst, it appears that haloperidol was as effective or more effective compared to the new meds, yet is about 1-5% of the cost. Hmmm... And it ain't like Haldol is a wonder drug. This is one of a number of recent articles that has found the second generation antipsychotic meds have been highly overrated. Feel free to check out my prior posts on the topic, including this, this, this, this, and this.