A drug used to treat schizophrenia, and with a history unlike any other, is associated with longer life compared to more commonly used antipsychotic medications. An 11-year study in Finland (n=67,000), published in The Lancet, indicate people taking clozapine (generic name) live longer than those taking Seroquel, Zyprexa or Risperdal, also used to treat schizophrenia.
Originally known by the brand name Clozaril, the drug was developed in Europe by Sandoz (now Novartis), and for a short time available in the United States during the late 1970s. But a concern developed around a rare side effect which causes a sudden drop in bacteria-fighting white blood cells. If untreated, this causes death, and the drug was pulled from the American market. After stringent testing showed its superior results, clozapine was later allowed in conjunction with mandatory weekly blood tests. It received FDA clearance for the most serious cases of schizophrenia where patients had previously failed two medications. This standard, and the concern with side effects, reduced clinical interest in the drug in the US.
Worldwide, and especially in Europe writes science historian John Crilly, where public health systems permit easy monitoring, the drug became common. By then, monitoring costs in the US discouraged widespread use. Although the FDA approved the drug in 1989, it was inaccessible through Medicaid and families and advocates successfully sued states to make it available in the early 1990s. The system for blood testing was also found illegal.
About one in five people with schizophrenia receive the medicine in Finland, and about five in 100 in the US. The authors of this study expect their findings to renew interest in the drug.
Long-term treatment with antipsychotic drugs is associated with lower mortality compared with no antipsychotic use. Second-generation drugs are a highly heterogeneous group, and clozapine seems to be associated with a substantially lower mortality than any other antipsychotics. Restrictions on the use of clozapine should be reassessed.
Clozapine has been a godsend for my brother. Over the past 10 years he has tried to switch over to many of the newer anti-psychotics, but none have come close to being as effective. He was labeled "treatment-resistant" a "refractory case" and recommended for full-time commitment to a state institution until Clozapine came to the rescue in 1994 (when our state approved its use).
Worries me that our newest generation of psychiatrists are encouraged to use the more recent drugs when Clozapine has such a powerful track record.
Posted by Katie Cadigan | July 14, 2009 11:17 PM