Ageing atypical could help cut suicide levels
pharmafile | October 28, 2003 | News story | |Â Â Â
Novartis' atypical antipsychotic Clozaril could lead to a reduction in suicide rate among patients suffering from schizophrenia, according to a new study.
Results from the International Suicide Preventions Trial (InterSePT), published in the Archives of General Psychiatry, found that patients with schizophrenia or schizoaffective disorder taking Clozaril (clozapine) showed significantly lower levels of suicidal behaviour than patients taking Eli Lilly Zyprexa (olanzapine).
This follows an FDA approval in December of Clozaril for the treatment of suicidal behaviour in schizophrenia patients, the first time a drug has been specifically licensed for this indication. Clozaril now has three yearsUS market exclusivity for the indication. Data on which the FDA made its decision also came from the Novartis-funded InterSePT trial.
Novartis recently filed for a similar indication across Europe and is hoping for a positive outcome by the middle of the year.
In the UK, Prof Robert Kerwin, professor of clinical neuropharmacology at the Institute of Psychiatry at King College, London, says wider use of Clozaril could save up to 100 lives a year.
The Government has pledged to cut suicide rates by a fifth by 2010, and the target has been included in the controversial 2003 performance indicators for mental health trusts and PCTs. It is believed almost half of the 88,000 schizophrenics in the UK attempt suicide.
Mental health charities welcomed the findings of the study but called on the Government to make Clozaril more available and for doctors to prescribe it more quickly.
"While services continue to fail to respond to the needs of people at risk of suicide, we should at least ensure that people have access to medications with proven benefits and without debilitating side-effects such as the old 'typical' antipsychotic," said Marjorie Wallace, Chief Executive of SANE.
Clozaril is only licensed for treatment-resistant schizophrenia, but to be prescribed at the earliest opportunity. Patients prescribed Clozaril need to have tried at least two other antipsychotics, at least one of which should have been another atypical.
The drug carries with it a risk of neutropenia and potentially fatal agranulocytosis a severe lack of white blood cells and means patients must be registered with and constantly monitored through the Clozaril Patient Monitoring Service.
The drug was launched in 1989 and is suffering from generic competition in the US. Global sales in 2001 were $319 million and $234 million for the first nine months of 2002.
A survey by Rethink found that one in five PCTs have yet to implement the mandatory NICE guidance on atypicals, such as Zyprexa, Janssen-Cilag Risperdal and AstraZeneca Seroquel, which last year were recommended as a first line therapy for newly diagnosed schizophrenia.
The top selling antipsychotic globally in 2001 was Zyprexa, with sales of $3.1 billion, followed by Risperdal with $1.8 billion, and Seroquel with $700 million.
