Comparative Effectiveness of Antipsychotic Drugs: A Commentary on Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1) and Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)
"Perazine is a phenothiazine derivative widely used in some European countries, including Germany and Poland, and it is thought to exert potent antipsychotic and sedative effects, as well as a relatively low risk of extrapyramidal side effects (Leucht et al., 2014; Adamowski and Kiejna, 2012). Interestingly, recent naturalistic studies have demonstrated that the effectiveness of some typical and atypical antipsychotics did not differ in clinical settings (Lieberman, 2006; Lewis and Lieberman, 2008; Stahl, 2008; Leucht et al., 2009; Naber and Lambert, 2009). At the time of study conception, perazine and olanzapine were the two most widely used antipsychotic drugs at both recruiting centers and ziprasidone had just been introduced to the Polish market. "
[Show abstract][Hide abstract] ABSTRACT: The primary aim of the present study was to assess the possible associations between dopaminergic, serotonergic, and glutamatergic system-related genes and adverse events after antipsychotic treatment in paranoid schizophrenia patients. The second aim of the study was to compare the intensity of these symptoms between atypical (ziprasidone and olanzapine) and typical (perazine) antipsychotic drugs. One-hundred and ninety-one Polish patients suffering from paranoid schizophrenia were genotyped for polymorphisms of DRD2, DAT1, COMT, MAOA, SERT, 5HT2A, and GRIK3. The patients were randomized to treatment with perazine, olanzapine or ziprasidone monotherapy for 3 months. The intensity of side effects (changes in body weights and extrapyramidal symptoms (EPS)) was measured at baseline and after 12 weeks of antipsychotic treatment. After 3 months of therapy, the weight increase was the greatest in the group treated with olanzapine and the least in the group treated with ziprasidone. None of the examined gene polymorphisms was associated with the body weight changes. Perazine treatment was associated with the significantly highest intensity of EPS. None of the examined polymorphisms was associated with the changes in extrapyramidal adverse events after antipsychotic treatment. The selected polymorphisms are not primarily involved in changes in body weights and EPS related to antipsychotic treatment in paranoid schizophrenia patients.
Psychiatry Research 06/2014; 219(2). DOI:10.1016/j.psychres.2014.05.039 · 2.47 Impact Factor
"The very fact of the debate should give one pause. As Jeffrey Lieberman (2006) has commented, evidence from a number of recent trials 'should dispel the illusion of the vast superiority of the SGAs,' and, if this is so, 'how are we to explain the enthusiastic claims that the SGAs have greater efficacy against' a host of psychotic symptoms? In the end, the process of making sense of evidence is not straightforward. "
"(2003) wskazują na niewielką przewagę skuteczności nowszych leków, to szereg badań [m.in. analiza Liebermana (2006) oraz praca Rosenhecka i wsp. (2003)] wskazuje, że leki atypowe nie przewyższają leków klasycznych w zakresie skuteczności objawowej i wpływu na jakość życia. "
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