Highlights

Clozapine Warning Updated

In 2006, the manufacturer of clozapine (Clozaril) added new warning information to the drug’s prescription label. The new information advises doctors to monitor the absolute neutrophil count, as well as total white blood cell count, in patients taking this drug. Clozapine can sometimes cause a drastic drop in neutrophils (agranulocytosis), a condition that can be life-threatening.

Newer Versus Older Antipsychotics

Several 2006 studies support earlier research indicating that older first-generation antipsychotic drugs work as well and are more cost-effective than newer second-generation (“atypical”) antipsychotics.

• A study in the Archives of General Psychiatry suggested that for patients who need their medication changed, older antipsychotic drugs provide as good or better improvement in quality of life and symptom control as newer antipsychotics.
• Results from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), reported in the American Journal of Psychiatry, indicated that the older drug perphenazine (Trilafon) is less expensive and works just as well as newer drugs such as olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon).

Antipsychotics for Children and Adolescents

More children are being prescribed atypical antipsychotics for schizophrenia and other mental disorders, despite the lack of evidence for long-term safety and efficacy warns a 2006 study in the Archives of General Psychiatry. These drugs are approved only for adults but are being increasingly prescribed to pediatric patients.

Famine and Schizophrenia

Epidemiologic studies have noted that children born during times of famine are more than twice as likely to develop schizophrenia as those born during non-famine years. New research in the Journal of the American Medical Association suggests that folate deficiencies in malnourished pregnant women may be the link. A lack of folate in the mother’s diet could cause genetic mutations in the developing fetus that increase the risk for schizophrenia.

Review Date: 12/21/2006
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

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