CATIE - Phase 2

The National Institute of Mental Health has released further findings from its large-scale examination of treatments for schizophrenia in its Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE).

The initial results were presented last September, and were chiefly a comparison of various anti-psychotics when used as initial or first-line treatments for the symptoms of schizophrenia. The outcomes from the first stage of this large-scale study were widely reported in the national media, principally because an older and far cheaper antipsychotic of the previous generation had results analogous to "atypical" antipsychotic medications that are many times more expensive.

Results from CATIE’s second phase are reported in the April issue of the American Journal of Psychiatry and evaluate how various antipsychotics perform as second-line medications, i.e., ones that are tried after another is discontinued. The clear winner for performance in CATIE’s second round is clozapine, which was not tested in the first phase. 44% of patients who took clozapine (brand name: Clozaril) after trying another anti-psychotic stayed on it for the rest of the 18-month study, versus only 18% who switched to the other medications tested.

We caution, however, that determining what medication should and can be used for a particular person entails far more considerations than the results of a single study (no matter how large or well-constructed). Different things work for different people.