CATIE and CUtLASS: can we handle the truth?

The British Journal of Psychiatry (Impact Factor: 7.99). 04/2008; 192(3):161-3. DOI: 10.1192/bjp.bp.107.037218
Source: PubMed


Two large, non-commercial clinical trials comparing first- and second-generation antipsychotic drugs for people with chronic schizophrenia in the US and UK have shown unexpected results. in general, the newer drugs were no more effective or better tolerated than the older drugs. Clozapine outperformed other second-gene ration drugs. The implications are considered. Declaration of interest S.L. is the Chief investigator of the CUtLASS study and J.L. is the Chief Investigator of the CATIE study, S.L. has received honoraria from several pharmaceutical companies. J.L. has received research funding from several pharmaceutical companies.

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Available from: Shôn Lewis, Oct 26, 2015
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    • "Moreover, findings of slightly positive effects of some atypical AP on cognitive deficit were reported in SZ (e.g., Peuskens et al., 2005; Houthoofd et al., 2008) and these findings were supported by results in an animal model of SZ (Bubeníková et al., 2005). However, when atypical antipsychotics were directly compared with the typical ones, no differences were found in either psychomotor functions or other cognitive areas (Jones et al., 2006; Keefe et al., 2007; Lewis and Lieberman, 2008). "
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    • "In terms of outcomes related directly to symptoms of mental illness, research has suggested the relative efficacy of first-and second-generation antipsychotics (Leucht et al., 2009). For treatment-resistant patients Clozapine has demonstrated relative efficacy above other second-generation drugs (Lewis & Lieberman, 2008). Over half of all service users were currently prescribed the atypical antipsychotic Clozapine (56.7%). "
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    • "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. "
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