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Atypical Antipsychotics Study Offers New Consideration for Clozapine
In the July 13, 2009, on-line issue of The Lancet, Finnish researchers reported
that patients using clozapine are less likely to die prematurely than patients using
other atypical antipsychotic drugs, such as Risperdal® (risperidone), Zyprexa® (olanzapine),
and Seroquel® (quetiapine) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60742-X/abstract).
In this study Finnish researchers analyzed 67,000 patient records in Finland and
compared treatment with atypical antipsychotics against perphenazine, a first generation
typical antipsychotic drug. The results showed that the risk of early death for
patients on clozapine was reduced by 26 percent. In contrast to clozapine, mortality
risk increased 41 percent for patients on Seroquel®, 34 percent for patients taking
Risperdal®, and 13 percent for patients treated with Zyprexa®.
The study leader, Jari Tiihonen of the University of Kuopio, posited whether clozapine
should be reassessed as a first-line treatment option in light of these findings.
Current use of clozapine has been limited due to safety concerns and the requirement
of regular blood tests. Tiihonen and his colleagues indicated the importance of
clozapine in potentially lowering premature deaths worldwide during treatment regimens
involving atypical antipsychotics.
The Finnish study also found no pronounced differences in heart deaths among the
different atypical antipsychotics. Patients on clozapine, however, experienced a
lower risk of suicidality compared to a higher risk from use of Seroquel® .
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