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flakjak

The Glutamate Theory of Schizophrenia

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It's news to me that olanzapine is 'the best currently available drug' for schizophrenia :P

Wait and see, I guess...

If it makes it to licensing, what do you think they'll call it?

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To be little away for my usual cynical self... ::)

It is very important for us to be hopeful... This really is good news... Although glutamate theory has been hanging around for some time, I think this is one step forward....

Now back to my cynical self... :P

We have heard this before... when Aripirazole came out first... it was supposed to be the wonder drug...

We know where it belongs now...

But anything different from the dopamine stuff is a welcome change...

Ros... The claim of olanzapine being the best drug... is probably form CATIE...

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Best tolerated...fair enough- as long as you don't mind making space for a BM machine on your mantlepiece...... ;)

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Thanks for the heads up, I be eating chicken chow mein with my PCP from now on!

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In the trial, 196 schizophrenic patients were treated with either LY2140023, olanzapine, or a placebo for [highlight]four weeks[/highlight]. The drugs were roughly equally effective, the researchers report in Nature Medicine1

is this time sufficient to come to the conclusion about the efficacy ?

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In the trial, 196 schizophrenic patients were treated with either LY2140023, olanzapine, or a placebo for [highlight]four weeks[/highlight]. The drugs were roughly equally effective, the researchers report in Nature Medicine1

is this time sufficient to come to the conclusion about the efficacy ?

well.... equal drop in PANSS in all three groups will do...

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no theory works well, cause schizophrenia is not one condition and does not have one cause. a simple chemical imbalance type theory with one transmitter being implicated will never work.

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I don't think you can treat schizophrenia with just a drug as it is a syndrome. But I guess they are trying to find the best drug to controll some of the symptoms with the best drug available with least side effects.

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Best tolerated...fair enough- as long as you don't mind making space for a BM machine on your mantlepiece...... ;)

The CATIE trial does not show that Olanzapine was the best tolerated antipsychotic.  It does show that patients on Olanzapine were more likely to still be on Olanzapine at the end of the 18 month study.

N Eng J Med 355;12 Page 1220:

&quot:lol:iscontinuation of treatment owing to intolerability:

Olanzapine 18%

Quetipine 15%

Risperidone 10%

Perphenazine 15%

Ziprasidone 15%

P = 0.04'

So infact the  CATIE trial shows a statistically significant result that Olanzapine is the least tolerated medication.

Patients in the CATIE trial remained on Olanzapine for other reasons.  Suggestions welcome.

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Thanks for that, Freedman! My education continues... ;)

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catie is actually very complex to interpret.

the different phases showed different results.

you can draw lots of simple conclusions, but there is only one simple conclusion that is correct - the majority of patients do not continue the drug that is prescribed either because of lack of efficacy or intolerable side effects. from then on it all gets more complex.

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no theory works well, cause schizophrenia is not one condition and does not have one cause.  a simple chemical imbalance type theory with one transmitter being implicated will never work.

Spot on... Thats excactly why this is going to be a hoax on its own...

It will be intersting to see how a combination of stuff works... back to rational polypharmacy stuff...

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j.

You are quite right.

In reality the result I have quoted could be confounded by the fact that patients took Olanzapine for longer.

The same table provides the results for lb increase in weight, and then lb/month of treatment. Olanzapine still makes you fatter than the other medications, but the results are not quite so impressive.

I suspect that if the result of intolerability/month of treatment was included then they would all be the same.

Even so there is a myth that CATIE showed that Olanzapine was the best tolerated medication. As I stated above, it didn't.

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