David Earl Johnson, LICSW

2 minute read

Anti-psychotic medication has gotten very expensive, especially when compared to long standing generics. Now research is finding the generics work just as well as the new “atypicals”. But the fact is, medication has to be subscribed one client at a time. While on average, some of the generics work as well with low side effects, some individuals have extreme side effects from the generics or don’t benefit from them any where near as effectively as the new “atypicals”. In particular, the worse permanent side effect, tardive dyskinesia appears less likely with new atypicals in individuals prone to that problem. So when we have journal articles pointing out the excesses of the pharmeceutical industry, we need to be sure we don’t eliminate the best option for the minority of persons who need the new “atypical” anti-psychotic medications. Archives of General Psychiatry

In people with schizophrenia whose medication is changed for clinical reasons, there is no disadvantage across 1 year in terms of quality of life, symptoms, or associated costs of care in using FGAs rather than nonclozapine SGAs. Neither inadequate power nor patterns of drug discontinuation accounted for the result. Here is a [NAMI.org press release][2] supporting my position.

“For Medicare, Medicaid, and the Department of Veterans Affairs, it would be a grave mistake to use the study to restrict access to newer medications, based on general findings that older medications seem to work as well as the newest generation,” Duckworth said. “General findings cannot be substituted for specific choices made in treating individuals with schizophrenia. One size does not fit all. It is critical that the study’s limitations be recognized.” For one, the British study relies heavily on an older drug, sulpiride that has never been approved by the Food & Drug Administration (FDA) and is unavailable in the United States. In addition, the study’s comparisons are limited to classes of drugs, rather than specific medications. The study does not include comparison of doses of drugs, either between classes or specific medications. Although longer than clinical trials required for FDA approval of specific drugs, the study’s one-year test period is still largely inadequate for evaluating treatment outcomes over time.

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