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Washington, DC (December 1, 2006) — The latest findings from the federal study, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), were published today in the American Journal of Psychiatry. The National Council for Community Behavioral Healthcare commends the study for attempting to address important human and societal issues but cautions that public and private insurers must not use the findings to restrict or reduce access to the full array of psychiatric medications. The findings are most helpful in the questions they raise, not the answers they provide.

The new CATIE release analyzes the economic implications of antipsychotic prescribing practices in the United States and concludes that treatment with an older antipsychotic, perphenazine, is less costly than treatment with second-generation antipsychotics. However, the investigators point out that the short period of the study and high dropout rates did not permit them to assess the risk and cost implications of longer-term neurological and metabolic syndromes.

One of the most serious neurological side effects to consider is tardive dyskinesia — repetitive, involuntary, and purposeless muscle movements. Tardive dyskinesia is a known, long-term and irreversible side effect of older drugs like perphenazine prescribed to treat schizophrenia. It can stigmatize, isolate and debilitate an individual more than the illness itself. The newer drugs overcome the extreme consequences that can result from the older drugs but have metabolic side effects.

In determining which medicines to use in treating schizophrenia, psychiatrists and patients must continuously weigh symptom relief vs. side effects and develop a prescribing plan that is tailored to the individual and takes into account history and preference. CATIE confirms that individuals with schizophrenia respond very differently to different medications. Finding the right medication is critical, as research has repeatedly shown that those who consistently take medication do much better than those who don’t. Psychiatrists must be able to prescribe from the full array of medicines.

Treatment for schizophrenia must include community support, education about the illness, ongoing reviews of the effects of prescribed medications and a range of rehabilitation services. CATIE stimulates important discussions, but more research is needed before we consign our most vulnerable citizens to the cheapest, not the best, care.
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The National Council for Community Behavioral Healthcare is a not-for-profit 501(c)(3) association representing 1,300 mental health and addictions treatment and rehabilitation organizations that serve nearly six million adults, children, and families in communities across America.