Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI) has issued the following statement on studies funded by the National Institute of Mental Health (NIMH), published today in the American Journal of Psychiatry on the treatment of schizophrenia:
"The latest findings in NIMH's Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) provide important guideposts.
First, choices exist among medications. One size does not fit all.
Second, medication alone is not enough to overcome the illness.
Medications reduce symptoms, but no difference exists between medications in moving beyond modest improvement toward restoration of interpersonal and community living skills.
Like earlier CATIE findings, the results show that older generation antipsychotic medications remain as effective as newer ones. More significantly, when an older medication becomes ineffective, some newer medications help sooner than others.
No matter what medication is prescribed, intensive rehabilitation and support services are essential to improve the functioning of people who live with schizophrenia. Those services include family education, permanent supported housing, vocational rehabilitation, and assertive community treatment (ACT), which are all neglected in our overall system of care.
Individuals and families living with schizophrenia have known these facts for years. We know that they are underplayed and underpaid by insurance and public investment. With CATIE, the scientific community is finally catching up with the families.
The latest research therefore also provides guidance-and warnings-to policymakers, including legislators.
Choosing medications is a medical decision that must be made on an individual basis.
Access to both older and newer generation medications must be preserved in Medicaid or managed care, to ensure maximum choice for maximum effectiveness.
We need to provide, and fully fund, community services. That is the only way to help people who live with schizophrenia to achieve their highest level of function.
Finally, we need better options.
Scientific research is part of the equation.
CATIE compares one generation of drugs to a second generation. What is needed is a third generation that can take us even farther toward effective treatment and recovery.
NIMH also needs to support closer research on medication adherence by consumers, which the studies show is a key to effective treatment.
NAMI
http://www.nami.org/
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