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Latest Schizophrenia Drug Studies: One Size Does Not Fit All; Community Services also Needed

Statement of Ken Duckworth, M.D, Medical Director
National Alliance on Mental Illness (NAMI)

March 1, 2007

Arlington, VA -- The American Journal of Psychiatry today published two studies representing the most recent installment of the "Clinical Antipsychotic Trials of Intervention Effectiveness" (CATIE) funded by the National Institute of Mental Health (NIMH) in the treatment of schizophrenia.

Ken Duckworth, M.D., medical director of the National Alliance on Mental Illness (NAMI) issued the following statement commenting on the studies:

"The latest findings provide two important guideposts for doctors and consumers.

First, choices exist among medications for schizophrenia. One size does not fit all.

Second, medication alone is not enough to overcome the illness. Medications reduce symptoms, but no difference exists between medications in moving beyond modest improvement to restoration of interpersonal and community living skills.

Like earlier CATIE findings, the latest results show that older generation antipsychotic medications remain as effective as newer drugs.   More significantly, they show that when an older medication is effective, some of the newer medications help sooner than others. This may seem obvious, but the independent, comparative  evidence is important in making real world choices.

No matter what medication is prescribed, intensive rehabilitation and support services are essential to improve the functioning of people who live with schizophrenia. Those services include family education, permanent supported housing, vocational rehabilitation, and assertive community treatment (ACT) – which traditionally are neglected in our overall system of care.

Individuals and families living with schizophrenia have known these facts for years. We know that counseling and job services are underplayed and underpaid by insurance and public investments.  With CATIE, the scientific community is finally catching up with the families.

The latest research installment therefore also provides guidance -- and warnings -- to policymakers, including legislators.

Choosing medications is a medical decision that must be made on an individual basis. Access to both older and newer generation medications must be preserved in Medicaid and managed care plans, to ensure maximum choice for maximum effectiveness.

We need to provide, and fully fund, community services. That is the only way to help people who live with schizophrenia achieve their highest level of function.

Finally, we need better options.

Scientific research is part of the equation.

CATIE compares one generation of drugs to a second generation.

What is needed is a third generation that can take us even farther toward effective treatment and recovery.

NIMH also needs to support closer research on promotion of medication adherence by consumers, which the studies show is a key to effective treatment.”

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American Journal of Psychiatry articles: http://ajp.psychiatryonline.org/

NIMH News Release

 

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