NIH reports antipsychotic data

NIH said data from the U.S. TEOSS study showed that second-generation antipsychotics olanzapine and risperidone were no better than molindone plus benztropine to treat schizophrenia when given for eight weeks. The double-blind study, which enrolled 116 schizophrenics 8-19 years old, also showed that patients on olanzapine and risperidone gained significantly more weight vs. molindone. In 2006, a DSMB discontinued randomization to the study's olanzapine arm due to weight gain without evidence of better efficacy. Molindone was associated with more akathisia but not with more Parkinsonian or dystonic symptoms. Data were published in The American Journal of Psychiatry.

Limitations of the study cited by the authors included the small sample size and the choice of molindone, which is not commonly used in clinical practice. The authors also said the use of benztropine with molindone may have minimized differences in extrapyramidal symptoms. Regardless of these limitations, the authors concluded, "These results question the nearly exclusive use of atypical antipsychotics to treat EOSS [early onset schizophrenia] and also highlight the limited therapeutic response and increased side effect sensitivity of youth compared to adults." ...