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Published online by Cambridge University Press:  02 January 2018

Peter Lepping*
Affiliation:
University of Wales, Llwyn-y-groes Psychiatric Unit, Wrexham Maelor Hospital, Wrexham LL13 7TD, Wales, email: peter.lepping@new-tr.wales.nhs.uk
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Abstract

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Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2007

I was surprised by the results of the recent study about which antipsychotics mental health professionals would take themselves (Psychiatric Bulletin, 31, ). I was particularly surprised about the popularity of aripiprazole (18.6%) and quetiapine (11.2%), because this is in sharp contrast to recent results suggesting that these are likely to be less effective than olanzapine, risperidone and amisulpride when outcome measures other than Positive and Negative Syndrome Scales (PANSS) scores are applied. This is true for in-patient (Reference Mccue, Waheed and UrcuyoMcCue et al, 2006) and out-patient settings (Reference Lieberman, Stroup and McevoyLieberman et al, 2005; Reference El-Sayeh, Morganti and AdamsEl-Sayeh et al, 2006; Reference Haddad and DursunHaddad & Dursun, 2006; Reference Jones, Barnes and DaviesJones et al, 2006).

Despite this emerging evidence, amisulpride was only preferred by 1.1% and clozapine by 6.9%. It was particularly disconcerting that aripiprazole was preferred by 18.6%, although most people admitted that they had hardly any experience with this drug. It is possible that aripiprazole is seen as being relatively free of side-effects because professionals have not accumulated any experience with the drug and that they are responding to undue influence from pharmaceutical representatives. The study certainly throws up the question why major research results either do not filter through or are not being considered, despite very little evidence with certain drugs. Results from independently funded studies should be disseminated to all colleagues. This may have to be facilitated locally by academic psychiatrists or postgraduate education programmes.

References

El-Sayeh, H. G., Morganti, C. & Adams, C. E. (2006) Aripiprazole for schizophrenia: systematic review. British Journal of Psychiatry, 189, 102108.CrossRefGoogle ScholarPubMed
Haddad, P. & Dursun, S. M. (2006) Selecting antipsychotics in schizophrenia: lessons from CATIE. Journal of Psychopharmacology, 20, 332334.CrossRefGoogle ScholarPubMed
Jones, P. B., Barnes, T. R., Davies, L., et al (2006) Randomised control trial of the effect of quality of life of second versus first generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study. Archives of General Psychiatry, 63, 10791087.CrossRefGoogle Scholar
Lieberman, J., Stroup, T. S., Mcevoy, J. P., et al (2005) Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353, 12091223.CrossRefGoogle ScholarPubMed
Mccue, R. E., Waheed, R., Urcuyo, L., et al (2006) Comparative effectiveness of second-generation antipsychotics and haloperidol in acute schizophrenia. British Journal of Psychiatry, 189, 433440.CrossRefGoogle ScholarPubMed
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