Treatment of Schizophrenia: Discussion



Rajiv Tandon reminds us that since chlorpromazine, no less than 60 antipsychotic drugs have been marketed. Clozapine proved a milestone in treatment effectiveness for patients with schizophrenia. The subsequently developed atypical antipsychotic drugs, now known as second-generation antipsychotics (SGAs), were heralded as the first major advance in the therapeutics of schizophrenia for 40 years. These drugs seemed to have important advantages over first-generation (FGA; typical or conventional) drugs, including better efficacy for positive, negative, and mood symptoms, with fewer adverse effects and the possibility of improving cognition. It was claimed that the increased cost of the newer drugs would be offset by savings resulting from decreased hospital stays and use of health-care services.


Antipsychotic Drug Atypical Antipsychotic Drug Broad Inclusion Criterion Decrease Hospital Stay Generic Health Status Measure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Davies LM, Lewis SW, Jones PB, Barnes TRE, Gaughran F, Hayhurst K, Markwick A, Lloyd H, on behalf of the CUtLASS team (2007). Cost effectiveness of first generation versus second generation antipsychotic drugs to treat psychosis: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy. Br J Psychiatry 191: 14–22CrossRefPubMedGoogle Scholar
  2. Jones PB, Barnes TR, Davies L, Dunn G, Lloyd H, Hayhurst KP, Murray RM, Markwick A, Lewis SW (2006). Randomized controlled trial of effect on quality of life of second generation versus first generation antipsychotic drugs in schizophrenia – CUtLASS 1. Arch Gen Psychiatry 63: 1079–87CrossRefPubMedGoogle Scholar
  3. Kahn RS, Fleischhacker WW, Boter H, Davidson M, Vergouwe Y, Keet IP, Gheorghe MD, Rybakowski JK, Galderisi S, Libiger J, Hummer M, Dollfus S, López-lbor JJ, Hranov LG, Gaebel W, Peuskens J, Lindefors N, Riecher-Rössler A, Grobbee DE (2008). EUFEST study group. Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet 371(9618): 1085–97Google Scholar
  4. Lewis SW, Barnes TRE, Davies L, Murray RM, Dunn G, Kerwin R, Hayhurst K, Jones PJ (2006). Randomised controlled trial of effect on quality of life of prescription of clozapine versus other second generation antipsychotic drugs in resistant schizophrenia. Schizophr Bull 32: 715–23CrossRefPubMedGoogle Scholar
  5. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK (2005). Clinical Antipsychotic Trails of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 353(12): 1209–23CrossRefPubMedGoogle Scholar
  6. McEvoy JP, Lieberman JA, Stroup TS, Davis SM, Meltzer HY, Rosenheck RA, Swartz MS, Perkins DO, Keefe RS, Davis CE, Severe J, Hsiao JK (2006). CATIE Investigators. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment. Am J Psychiatry 163(4): 600–10Google Scholar
  7. Rosenheck R, Perlick D, Bingham S, Liu-Mares W, Collins J, Warren S, Leslie D, Allan E, Campbell EC, Caroff S, Corwin J, Davis L, Douyon R, Dunn L, Evans D, Frecska E, Grabowski J, Graeber D, Herz L, Kwon K, Lawson W, Mena F, Sheikh J, Smelson D, Smith-Gamble V (2003). Department of Veterans Affairs Cooperative Study Group on the Cost-Effectiveness of Olanzapine. Effectiveness and cost of olanzapine and haloperidol in the treatment of schizophrenia: a randomized controlled trial. JAMA 290(20):2693-702Google Scholar
  8. Rosenheck RA, Leslie D, Sindelar J, Miller EA, Lin H, Stroup S, McEvoy J, Davis S, Keefe RSE, Swartz M, Perkins D, Hsiao J, Lieberman JA (2006). Cost-effectiveness of second generation antipsychotics and perphenazine in a randomized trial of treatment for chronic schizophrenia. Am J Psychiatry 163(12): 2080–89CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Community-Based Medicine Research School University of ManchesterManchesterEngland

Personalised recommendations