A new meta-analysis of past research studies calls into question the assumption that the newer "atypical" antipsychotic medications have a much better side-effect profile than older antipsychotic medications. Stefan Leucht and colleagues reanalyzed all previous randomised controlled trials where new-generation antipsychotics had been compared with low-potency older medications.
The researchers analyzed 31 studies that included 2320 patients. Of the new generation drugs, clozapine was the only medication associated with fewer neurological side-effects and higher efficacy than the older (and cheaper) low-potency conventional drugs. The newer drugs were found to be "moderately more efficacious" than low-potency older antipsychotics.
This study was published in the May 2003 issue of The Lancet. In a press release written by the journal, Stefan Leucht summarized the findings: "Optimum doses of low-potency conventional antipsychotics might not induce more neurological side-effects than new generation drugs. Potential advantages in efficacy of the new-generation drugs should be a factor in clinical treatment decisions to use these rather than conventional drugs. However, if these findings are confirmed by future studies, there would be a good argument for the use of appropriately dosed conventional drugs-such as chlorpromazine-for patients with schizophrenia in settings where new-generation drugs are not generally affordable."
