July 13, 2009

comment on new research on the antipsychotic drug clozapine, as published in The Lancet

An analysis of ten years’ medical records for 67,000 people in Finland found that giving the drug to schizophrenia patients is associated with a reduction in death rates by 26 per cent. This has lead to more controversy, as the drug, clozapine, is widely regarded as the most effective treatment for schizophrenia but its availability has often been restricted due concerns over its safety.

Prof Les Iversen, Professor of Pharmacology, University of Oxford, said:

“This is a surprising result, but I cannot agree that clozapine should ever be the drug of first choice for treating schizophrenia. This is because the adverse side effect of agranulocytosis is serious and can be life threatening. It occurs in about 2% of patients, and all patients require tedious and costly monitoring – initially weekly, later monthly to detect this side effect. For this reason, clozapine has become a drug of ‘last resort’ – and will probably remain so.

“It is worth noting that while antipsychotic drugs may save lives among schizophrenic patients, they have the opposite effect when used in elderly demented patients – where increased mortality of up to 20-30% has been observed after 1 year treatment.”