January 15, 2009, 9:03 am
Newer Antipsychotic Drugs Double Heart Risk, Just Like Older Meds
Posted by Sarah Rubenstein
The prevailing wisdom that the latest generation of antipsychotics is safer than older medicines takes a hit in the current issue of the New England Journal of Medicine.
A study comparing the drugs finds: Patients taking the newer group of drugs, called atypicals, are twice as likely to suffer sudden cardiac failure and death as nonusers. They’re just as likely to suffer those problems as if they were taking the older antipsychotics. The risk of death wasn’t high, though, at 3% for a patient treated for 10 years, as the New York Times explains it.
Sales of atypical antipsychotics have grown sharply in recent years, reaching $13 billion through the first 11 months of 2008, according to IMS Health, as quoted by the WSJ. The atypicals are supposed to help patients avoid side effects associated with the older meds, including involuntary, sometimes irreversible tremors and tics and increased risk of sudden cardiac death.
An accompanying editorial argues that use of the atypical drugs in children and elderly patients should be “reduced sharply.” (See more on risks in the Alzheimer’s patients and children.)
Jerry Avorn, a Harvard Medical School professor who has criticized drugmakers’ marketing practices and who co-authored the editorial, questioned the marketing of atypical antipsychotics as a safer alternative to older, more conventional medicines. “Now we understand that they have their own problems that are quite substantial,” he told the WSJ.
The atypical drugs used in the study were AstraZeneca’s Seroquel, Eli Lilly’s Zyprexa, Johnson & Johnson’s Risperdal and Novartis’s Clozaril. The “typical” drugs used for comparison were haloperidol and thioridazine, both generics. A Lilly spokesman told the WSJ the study provides information physicians should consider when prescribing such drugs, but added that Zyprexa has helped millions with serious mental illnesses regain control of their lives.
As reported by The Wall Street Journal Health Blog - 1/15/09