You may not be able to teach an old dog new tricks, but you can learn to appreciate the tricks it already knows. Such may be the case with clozapine, one of the older schizophrenia drugs. It's been relegated to a third-line treatment, and discounted because of a rare-but-serious blood side effect. But a new study shows that patients using clozapine--sold as Clozaril by Novartis and as a generic--are less likely to die prematurely than are patients using newer atypical antipsychotics.
Finnish researchers analyzed 67,000 patients' records and compared atypical antipsychotics with an older schizophrenia remedy. Compared with that drug, clozapine patients were 26 percent less likely to die early. By contrast, the risk of early death was 41 percent higher for Seroquel patients, 34 percent higher for Risperdal patients and 13 percent higher for Zyprexa patients.
The new data could prompt a reassessment of clozapine--and it should, the study's lead author told Reuters."We know that clozapine has the highest efficacy of all the antipsychotics and it is now clear, after all, that it is not that risky or dangerous a treatment," study leader Jari Tiihonen explained. "We should consider whether clozapine should be used as a first-line treatment option."
Atypical antipsychotics have been plagued by safety questions, particularly about their effects on metabolism and weight, and their potential to trigger diabetes. Still, they're big-time sellers for AstraZeneca, Johnson & Johnson and Eli Lilly. If clozapine is safer than previously thought, and more effective than previous-generation schizophrenia meds--and it's available as a lower-cost generic--then payers tired of shelling out billions for the branded antipsychotics might just change their ways. Provided regulators agree with the new data, of course.
- read the Reuters story
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