Atypical antipsychotic agents; Peas in a pod or chalk and cheese?

BMC Medicine

Michael Berk³  Lakshmi N Yatham²  Andrew A Nierenberg⁴  Ajeet B Singh¹ 

[1] IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong 3220, Australia;Department of Psychiatry, University of British Columbia, Vancouver V6T 1Z3, BC, Canada;Department of Psychiatry, University of Melbourne, Parkville, 3052, Australia;Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, 50 Staniford Street, Boston 02114-2517, MA, USA

关键词: Health economics;    Generic;    Schizophrenia;    Bipolar;    Risperidone;    Atypical antipsychotics;   

Others  :  1121574
DOI  :  10.1186/s12916-014-0126-1

 received in 2014-07-10, accepted in 2014-07-10,  发布年份 2014

【 摘 要 】

With escalating health expenditure and a shrinking purse, there is increased focus on the cost efficacy of still patented versus generic medications in general, and for atypical antipsychotics in particular. In a recent BMC Medicine article, Godman and colleagues presented data indicating poor uptake of the off patent atypical antipsychotic risperidone, arguing for authorities to mandate its greater use. This is under the assumption of clinical equivalence of atypical antipsychotics. This commentary argues that there are clinically meaningful differences between atypical antipsychotics and important inter-individual heterogeneity in clinical response and tolerability. Access to a broad range of atypical antipsychotics enables clinicians to tailor care, taking consideration of differential efficacy and adverse effects profile in order to meet the needs of individual patients with improved real world effectiveness of treatment. Restriction of agent choice risks detracting from optimal clinical care, with possible poorer outcomes and greater costs of care. A balance between encouraging use of cheapest in class agent and allowing access to various atypical agents for tailored care is likely to produce optimal health outcomes.

Please see related article: http://www.biomedcentral.com/1741-7015/12/98 webcite.

【 授权许可】

   
2014 Singh et al.

【 参考文献 】

• [1]Godman B, Petzold M, Bennett K, Bennie M, Bucsics A, Finlayson AE, Martin A, Persson M, Piessnegger J, Raschi E, Simoens S, Zara CBC: Can authorities appreciably enhance the prescribing of oral generic risperidone to conserve resources?: findings from across Europe and the implications. BMC Med 2014, 12:98. BioMed Central Full Text
• [2]Leucht S, Cipriani A, Spineli L, Mavridis D, Orey D, Richter F, Samara M, Barbui C, Engel RR, Geddes JR, Kissling W, Stapf MP, Lässig B, Salanti G, Davis JM: Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet 2013, 382:951-962.
• [3]Hasan A, Falkai P, Wobrock T, Lieberman J, Glenthoj B, Gattaz WF, Thibaut F, Möller HJ: World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects. World J Biol Psychiatry 2013, 14:2-44.
• [4]Innamorati M, Baratta S, Di Vittorio C, Lester D, Girardi P, Pompili M, Amore M: Atypical antipsychotics in the treatment of depressive and psychotic symptoms in patients with chronic schizophrenia: a naturalistic study. Schizophr Res Treatment 2013, 2013:423205.
• [5]Selle V, Schalkwijk S, Vázquez GH, Baldessarini RJ: Treatments for acute bipolar depression: meta-analyses of placebo-controlled, monotherapy trials of anticonvulsants, lithium and antipsychotics. Pharmacopsychiatry 2014, 47:43-52.
• [6]Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, O'Donovan C, Macqueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M: Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disord 2013, 15:1-44.
• [7]Spielmans GI, Berman MI, Linardatos E, Rosenlicht NZ, Perry A, Tsai AC: Adjunctive atypical antipsychotic treatment for major depressive disorder: a meta-analysis of depression, quality of life, and safety outcomes. PLoS Med 2013, 10:e1001403.
• [8]Lam RW, Kennedy SH, Grigoriadis S, McIntyre RS, Milev R, Ramasubbu R, Parikh SV, Patten SB, Ravindran AV: Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. III. Pharmacotherapy. J Affect Disord 2009, 117:S26-S43.
• [9]Maneeton N, Maneeton B, Srisurapanont M, Martin SD: Quetiapine monotherapy in acute phase for major depressive disorder: a meta-analysis of randomized, placebo-controlled trials. BMC Psychiatry 2012, 12:160. BioMed Central Full Text
• [10]Maher AR, Maglione M, Bagley S, Suttorp M, Hu JH, Ewing B, Wang Z, Timmer M, Sultzer D, Shekelle PG: Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults: a systematic review and meta-analysis. JAMA 2011, 306:1359-1369.
• [11]Nord M, Farde L: Antipsychotic occupancy of dopamine receptors in schizophrenia. CNS Neurosci Ther 2011, 17:97-103.
• [12]Yatham LN, Goldstein JM, Vieta E, Bowden CL, Grunze H, Post RM, Suppes T, Calabrese JR: Atypical antipsychotics in bipolar depression: potential mechanisms of action. J Clin Psychiatry 2005, 66:40-48.
• [13]Horacek J, Bubenikova-Valesova V, Kopecek M, Palenicek T, Dockery C, Mohr P, Höschl C: Mechanism of action of atypical antipsychotic drugs and the neurobiology of schizophrenia. CNS Drugs 2006, 20:389-409.
• [14]Berk L, Hallam KT, Colom F, Vieta E, Hasty M, Macneil C, Berk M: Enhancing medication adherence in patients with bipolar disorder. Hum Psychopharmacol 2010, 25:1-16.
• [15]Narasimhan M, Un Pae C, Masand N, Masand P: Partial compliance with antipsychotics and its impact on patient outcomes. Int J Psychiatry Clin Pract 2007, 11:102-111.
• [16]Sun SX, Liu GG, Christensen DB, Fu AZ: Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States. Curr Med Res Opin 2007, 23:2305-2312.
• [17]Komossa K, Rummel-Kluge C, Schwarz S, Schmid F, Hunger H, Kissling W, Leucht S: Risperidone versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev 2011, 1:CD006626.
• [18]Ajmal A, Joffe H, Nachtigall LB: Psychotropic-induced hyperprolactinemia: a clinical review. Psychosomatics 2014, 55:29-36.
• [19]Williams LJ, Berk M, Henry MJ, Stuart AL, Brennan SL, Jacka FN, Pasco JA: Depression following fracture in women: a study of age-matched cohorts. BMJ Open 2014, 4:e004226.
• [20]Hodge JM, Wang Y, Berk M, Collier FM, Fernandes TJ, Constable MJ, Pasco JA, Dodd S, Nicholson GC, Kennedy RL, Williams LJ: Selective serotonin reuptake inhibitors inhibit human osteoclast and osteoblast formation and function. Biol Psychiatry 2013, 74:32-39.
• [21]Sacchetti E, Vita A, Siracusano A, Fleischhacker W: Adherence to Antipsychotics in Schizophrenia. Springer Milan, Milan; 2014.
• [22]Essock SM, Covell NH, Davis SM, Stroup TS, Rosenheck RA, Lieberman JA: Effectiveness of switching antipsychotic medications. Am J Psychiatry 2006, 163:2090-2095.
• [23]Treur M, Heeg B, Möller HJ, Schmeding A, van Hout B: A pharmaco-economic analysis of patients with schizophrenia switching to generic risperidone involving a possible compliance loss. BMC Health Serv Res 2009, 9:32. BioMed Central Full Text