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Treating schizophrenia

Research at The University of Manchester has reversed medical opinion on the advantages of 'wonder-drugs' used to treat schizophrenia.

Studies carried out by a team led by Professor Shôn Lewis demonstrated a second generation of anti-psychotic drugs was no more effective in treating a condition that affects 1% of the population and often leads to lifelong disability and problems.

Drugs first developed in the 1950s have positive benefits for two-thirds of people, but in the 1990s, a new kind of medication arrived, claiming the twin advantage of being more effective and tolerable to patients.

The new drugs were also 20 times more expensive, but with the help of an aggressive marketing campaign, they came to dominate the market.

In Greater Manchester alone, GP spending increased from £30,000 a month to £600,000 a month in four years.

The claim was the new drugs were still cost-effective as additional spend could be recouped from savings on inpatient stays due to lack of side-effects and greater tolerability.

The problem was that the evidence quoted was short-term and potentially biased in favour of the drug companies.

The aim of the CUtLASS - Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia - study was to test the theory the new drugs would lead to improved quality of life over a one-year period compared with their predecessors. Research carried out in Manchester in a study of patients aged between 18 and 65 defied expectations. It showed clearly that far from being a major advance the new drugs were no more effective.

Patients in the trial showed no preference for either kind of drug, there was no difference in side-effects and some actually enjoyed a better quality of life with the older medication.

Results of the findings first published in 2006 have had a worldwide impact and are shaping clinical guidelines in the UK, USA, Canada and other countries and changing prescribing practices back in favour of older medications.

In the UK, the research has also enabled the NHS to save money and develop other treatments for schizophrenia, including community care.

“Patients in the trial showed no preference for either kind of drug, there was no difference in side-effects and some actually enjoyed a better quality of life with the older medication.”

Shôn Lewis / Professor of Adult Psychiatry