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Antipsychotics preferred by mental health professionals

Consultant Psychiatrist and Honorary Senior Lecturer, University of Wales, Llwyn-y-groes Psychiatric Unit, Wrexham Maelor Hospital, Wrexham LL13 7TD, Wales, email: peter.lepping{at}new-tr.wales.nhs.uk

I was surprised by the results of the recent study about which antipsychotics mental health professionals would take themselves (Psychiatric Bulletin, 31, 94-96). I was particularly surprised about the popularity of aripiprazole (18.6%) and quetiapine (11.2%), because this is in sharp contrast to recent results suggesting that these are likely to be less effective than olanzapine, risperidone and amisulpride when outcome measures other than Positive and Negative Syndrome Scales (PANSS) scores are applied. This is true for in-patient (McCue et al, 2006) and out-patient settings (Lieberman et al, 2005; El-Sayeh et al, 2006; Haddad & Dursun, 2006; Jones et al, 2006).

Despite this emerging evidence, amisulpride was only preferred by 1.1% and clozapine by 6.9%. It was particularly disconcerting that aripiprazole was preferred by 18.6%, although most people admitted that they had hardly any experience with this drug. It is possible that aripiprazole is seen as being relatively free of side-effects because professionals have not accumulated any experience with the drug and that they are responding to undue influence from pharmaceutical representatives. The study certainly throws up the question why major research results either do not filter through or are not being considered, despite very little evidence with certain drugs. Results from independently funded studies should be disseminated to all colleagues. This may have to be facilitated locally by academic psychiatrists or postgraduate education programmes.

References

EL-SAYEH, H. G., MORGANTI, C. & ADAMS, C. E. (2006) Aripiprazole for schizophrenia: systematic review. British Journal of Psychiatry, 189, 102 -108.[Abstract/Free Full Text]

HADDAD, P. & DURSUN, S. M. (2006) Selecting antipsychotics in schizophrenia: lessons from CATIE. Journal of Psychopharmacology, 20, 332 -334.[Free Full Text]

JONES, P. B., BARNES, T. R., DAVIES, L., et al (2006) Randomised control trial of the effect of quality of life of second versus first generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study. Archives of General Psychiatry, 63, 1079 -1087.[Abstract/Free Full Text]

LIEBERMAN, J., STROUP, T. S., McEVOY, J. P., et al (2005) Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353, 1209 -1223.[Abstract/Free Full Text]

McCUE, R. E., WAHEED, R., URCUYO, L., et al (2006) Comparative effectiveness of second-generation antipsychotics and haloperidol in acute schizophrenia. British Journal of Psychiatry, 189, 433 -440.[Abstract/Free Full Text]

Related articles in PB:

Which antipsychotics would mental health professionals take themselves?

Stephen Bleakley, Olubanke Olofinjana, and David Taylor
PB 2007 31: 94-96. [Abstract] [Full Text]  

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in PB Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Lepping, P. Search for Related Content PubMed Articles by Lepping, P.