Restrictions on the use of the antipsychotic medicine clozapine may have led to thousands of additional deaths in schizophrenia patients around the world, a study published in The Lancet medical journal found.
Researchers examined data from patients taking the six most frequently used antipsychotic drugs and found that clozapine was associated with the lowest death rate compared with use of the older medicine perphenazine. Clozapine was linked to a 26 percent reduction in mortality according to the study, led by Jari Tiihonen at the University of Kuopio in Finland.
Doctors can prescribe clozapine, first developed by Switzerland’s Novartis AG, only after two unsuccessful trials with other antipsychotics because it has been linked with agranulocytosis, a condition causing a severe decrease in white blood cells and problems such as fevers, fatigue and bleeding sores, Tiihonen said. Patients taking clozapine need weekly blood monitoring for six months followed by monthly testing to look for signs of the disorder, he said.
“Our results raise the issue of whether clozapine should be used as a first-line treatment, because it seems to be the safest antipsychotic in terms of mortality and it is also the most effective,” Tiihonen and colleagues wrote in the study. “However, clozapine is inexpensive, and hence it’s unprofitable for the pharmaceutical industry to market compared with other second-generation antipsychotic drugs.”
READ MORE @ BLOOMBERG
Showing posts with label Clozapine. Show all posts
Showing posts with label Clozapine. Show all posts
Wednesday, July 15, 2009
Thursday, May 21, 2009
Choice of Antipsychotics Influence Metabolic Abnormalities in Patients With Schizophrenia:Presented at APA
A prospective trial comparing 3 antipsychotic drugs revealed that clozapine is most likely to produce metabolic changes that point the way to metabolic syndrome.
However, clozapine was also most likely to control violent behaviour and metabolic consequences were most apparent for African American, researchers stated here at the 162nd Annual Meeting of the American Psychiatric Association (APA).
Menahem Krakowski, MD, New York University, New York, and Nathan Kline Institute, Orangeburg, New York, presented the findings of a randomised, double-blind study on May 20.
The study included 110 inpatients with schizophrenia or schizoaffective disorder who were randomised to receive clozapine (n = 34), olanzapine (n = 31), or haloperidol (n = 28).
At study entry, 93 patients gave blood samples for measuring fasting glucose, cholesterol and triglycerides and had at least 1 more sample collected during the 12 weeks of the study. The patients had a history of physical assaults.
READ MORE @ DOCTOR'S GUIDE
However, clozapine was also most likely to control violent behaviour and metabolic consequences were most apparent for African American, researchers stated here at the 162nd Annual Meeting of the American Psychiatric Association (APA).
Menahem Krakowski, MD, New York University, New York, and Nathan Kline Institute, Orangeburg, New York, presented the findings of a randomised, double-blind study on May 20.
The study included 110 inpatients with schizophrenia or schizoaffective disorder who were randomised to receive clozapine (n = 34), olanzapine (n = 31), or haloperidol (n = 28).
At study entry, 93 patients gave blood samples for measuring fasting glucose, cholesterol and triglycerides and had at least 1 more sample collected during the 12 weeks of the study. The patients had a history of physical assaults.
READ MORE @ DOCTOR'S GUIDE
Thursday, March 27, 2008
Clozapine Better Than "High-Dose" Olanzapine for the Treatment of Adolescents With Schizophrenia
The results of a 12-week, double-blind, randomised study published in the March issue of Biological Psychiatry suggest that clozapine is more effective than "high-dose" olanzapine for the treatment of children and adolescents with schizophrenia who do not respond to standard, first-line antipsychotic treatment.
There is a wealth of scientific literature available on the treatment of adults with schizophrenia. However, there is a paucity of data to guide the treatment of children and adolescents with schizophrenia.
"Although the US Food and Drug Administration has recently approved the use of aripiprazole and risperidone for adolescents with schizophrenia, few controlled data are available to help guide clinicians regarding the management of children and adolescents with schizophrenia who fail to respond to these standard 'first-line' antipsychotic treatments," according to Dr. Sanjiv Kumra, University of Minnesota, Minneapolis, Minnesota, one of the authors of the study.
READ MORE @ DOCTOR'S GUIDE
There is a wealth of scientific literature available on the treatment of adults with schizophrenia. However, there is a paucity of data to guide the treatment of children and adolescents with schizophrenia.
"Although the US Food and Drug Administration has recently approved the use of aripiprazole and risperidone for adolescents with schizophrenia, few controlled data are available to help guide clinicians regarding the management of children and adolescents with schizophrenia who fail to respond to these standard 'first-line' antipsychotic treatments," according to Dr. Sanjiv Kumra, University of Minnesota, Minneapolis, Minnesota, one of the authors of the study.
READ MORE @ DOCTOR'S GUIDE
Tuesday, March 4, 2008
Comparison of antipsychotic treatments in adolescents with schizophrenia
There is a wealth of scientific literature available on the treatment of adults diagnosed with schizophrenia. However, there is a paucity of data to guide the treatment of children and adolescents with schizophrenia. “Although the U.S. Food and Drug Administration (FDA) has recently approved the use of aripiprazole and risperidone for adolescents with schizophrenia, few controlled data are available to help guide clinicians regarding the management of children and adolescents with schizophrenia who fail to respond to these standard 'first-line' antipsychotic treatments,” according to Dr. Sanjiv Kumra. Dr. Kumra is one of the authors of a new study to be published in the March 1st issue of Biological Psychiatry, which was undertaken to help fill this gap in knowledge.
The authors recruited 39 children, 10-18 years of age, who had already failed to respond to at least two antipsychotic treatments, to participate in a 12-week, double-blind, randomized study – the most rigorous of clinical trial designs. After initial assessments, the patients received treatment with either clozapine or “high-dose” olanzapine (doses that exceed the package insert recommendations) and were monitored for improvement in their symptoms. The researchers discovered that clozapine was approximately twice as likely to produce a treatment response as olanzapine. Both positive symptoms (psychosis) and negative symptoms (blunted emotional response, reduced motivation) responded better to clozapine. John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, comments on the findings: “Olanzapine is among the most effective antipsychotic medications, so the distinctive effectiveness of clozapine in this study could be very important.”
READ MORE @ EUREKALERT
The authors recruited 39 children, 10-18 years of age, who had already failed to respond to at least two antipsychotic treatments, to participate in a 12-week, double-blind, randomized study – the most rigorous of clinical trial designs. After initial assessments, the patients received treatment with either clozapine or “high-dose” olanzapine (doses that exceed the package insert recommendations) and were monitored for improvement in their symptoms. The researchers discovered that clozapine was approximately twice as likely to produce a treatment response as olanzapine. Both positive symptoms (psychosis) and negative symptoms (blunted emotional response, reduced motivation) responded better to clozapine. John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, comments on the findings: “Olanzapine is among the most effective antipsychotic medications, so the distinctive effectiveness of clozapine in this study could be very important.”
READ MORE @ EUREKALERT
Wednesday, February 20, 2008
Schizophrenia Drug’s Dosage Drives Success
The Vanderbilt physician who in the late 1980s established the antipsychotic drug clozapine as the gold standard for treating patients with treatment-resistant schizophrenia has improved on his own research.
Herbert Meltzer, M.D., director of the Schizophrenia Program in the Department of Psychiatry, and colleagues have shown that the success of clozapine in treating this population was not due to the unique pharmacologic features of the drug itself, but the fact that it was used at higher doses than what is used to treat patients with schizophrenia who respond well to antipsychotic drugs. Clozapine is rarely used for the 70 percent of patients whose psychotic symptoms respond well to a wide array of other antipsychotic drugs.
The study, published in the Jan. 23 issue of The Journal of Clinical Psychiatry and funded by Eli Lilly, included 40 men and women, ages 18 to 58, diagnosed with schizophrenia or schizoaffective disorder, which many think is part of the same spectrum of illness. Patients were recruited from three U.S. outpatient community mental health treatment facilities, including Nashville's Centerstone Mental Health Center.
The results showed that the drug olanzapine, whose pharmacology is considered closer to clozapine than that of any other drug available, when used at a higher dose than the established norm, is as effective as clozapine in improving psychopathology and cognition in treatment-resistant patients. The study showed that treatment-resistant patients taking higher doses respond more slowly than average patients taking conventional doses. In fact, both need to be given for six months before a good treatment response occurs, compared to six weeks for the average patient at the lower dose range.
READ MORE @ NEWSWISE MEDICAL NEWS
Herbert Meltzer, M.D., director of the Schizophrenia Program in the Department of Psychiatry, and colleagues have shown that the success of clozapine in treating this population was not due to the unique pharmacologic features of the drug itself, but the fact that it was used at higher doses than what is used to treat patients with schizophrenia who respond well to antipsychotic drugs. Clozapine is rarely used for the 70 percent of patients whose psychotic symptoms respond well to a wide array of other antipsychotic drugs.
The study, published in the Jan. 23 issue of The Journal of Clinical Psychiatry and funded by Eli Lilly, included 40 men and women, ages 18 to 58, diagnosed with schizophrenia or schizoaffective disorder, which many think is part of the same spectrum of illness. Patients were recruited from three U.S. outpatient community mental health treatment facilities, including Nashville's Centerstone Mental Health Center.
The results showed that the drug olanzapine, whose pharmacology is considered closer to clozapine than that of any other drug available, when used at a higher dose than the established norm, is as effective as clozapine in improving psychopathology and cognition in treatment-resistant patients. The study showed that treatment-resistant patients taking higher doses respond more slowly than average patients taking conventional doses. In fact, both need to be given for six months before a good treatment response occurs, compared to six weeks for the average patient at the lower dose range.
READ MORE @ NEWSWISE MEDICAL NEWS
Monday, September 10, 2007
Adverse drug reactions rise sharply, study says
The number nearly triples since the FDA began a new reporting system in 1998. The main culprits are painkillers.
The number of serious adverse events and deaths attributed to prescription medications has nearly tripled since the Food and Drug Administration initiated a system in 1998 to make it easier to report significant side effects, researchers said today.
Twenty percent of drugs accounted for 87.1% of adverse effects, and the biggest offenders were painkillers and drugs that modify the immune system to treat arthritis, according to the report in the Archives of Internal Medicine.
A quarter of the increase could be attributed to a boost in prescriptions and another 15% to the introduction of new biotechnology drugs since 1998, but the rest of the increase could not be explained, said drug safety expert Thomas J. Moore of the Institute for Safe Medication Practices in Huntingdon Valley, Pa.
READ MORE @ LOS ANGELES TIMES
The number of serious adverse events and deaths attributed to prescription medications has nearly tripled since the Food and Drug Administration initiated a system in 1998 to make it easier to report significant side effects, researchers said today.
Twenty percent of drugs accounted for 87.1% of adverse effects, and the biggest offenders were painkillers and drugs that modify the immune system to treat arthritis, according to the report in the Archives of Internal Medicine.
A quarter of the increase could be attributed to a boost in prescriptions and another 15% to the introduction of new biotechnology drugs since 1998, but the rest of the increase could not be explained, said drug safety expert Thomas J. Moore of the Institute for Safe Medication Practices in Huntingdon Valley, Pa.
READ MORE @ LOS ANGELES TIMES
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