A randomised, controlled trial of new atypical drugs versus clozapine in treatment-resistant schizophrenia [Abstract]

S W Lewis, L Davies, P. B. Jones, Thomas R E Barnes, R. M. Murray, R Kerwin, D Taylor, K P Hayhurst, A Markwick, H Lloyd, G Dunn

Research output: Contribution to journalMeeting Abstract


Background: A single-blind, multicentre RCT compared the class of new (non-clozapine) atypical drugs with clozapine in patients in the NHS whose medication was being changed because of poor clinical response to two or more antipsychotic drugs.
Methods: The primary outcome was the Quality of Life Scale. Secondary clinical outcomes included symptoms (PANSS), side effects and participant satisfaction. Economic outcomes were costs of health and social care and a utility measure. A total of 136 (98% of the planned sample) participants were randomised. Follow up at 52 weeks, blind to treatment allocation, was complete in 87%.
Results: The intent to treat comparison of new atypicals compared with clozapine in people with more narrowly defined treatment resistance showed an advantage for commencing clozapine in quality of life (QLS) at trend level ( p = 0.08) and in symptoms (PANSS), that was statistically significant ( p = 0.01), at 1 year. Clozapine showed approximately a 4-point advantage (not statistically significant) on QLS score at 52 weeks, against the predicted 10 points, and approximately a 5-point advantage on PANSS total score. Clozapine showed a trend towards having less total extrapyramidal side effects ( p = 0.1). Participants reported at 12 weeks that their mental health was significantly better with clozapine than with new atypicals ( p < 0.05). Net costs of care varied widely, with a mean of £33,588 in the clozapine group and £28,122 in the new atypical group, not a statistically significant difference. Of these costs, 4.0% and 3.3%, respectively, were due to antipsychotic drug costs.
Original languageEnglish
Pages (from-to)6-7
Number of pages2
JournalSchizophrenia Research
Issue number1
Publication statusPublished - 2004
Event12th Biennial Winter Workshop on Schizophrenia - Davos, Switzerland
Duration: 7 Feb 200413 Feb 2004


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