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Second generation antipsychotics are not superior in relieving family burden in schizophrenia compared with the first generation antipsychotic perphenazine

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Question

Question

Are second generation antipsychotics superior to first generation antipsychotics for reducing family burden associated with schizophrenia?

Patients

623 family caregivers of patients with schizophrenia (SCID diagnosed) enrolled in the CATIE trial. Main exclusions for patients: schizoaffective disorder, first episode schizophrenia, treatment resistant schizophrenia, mental retardation or other cognitive disorder.

Setting

57 US sites; January 2001 to December 2004.

Intervention

First generation antipsychotic (FGA: perphenazine) or one of four second generation antipsychotics (SGAs: olanzapine, quetiapine, risperidone, or ziprasidone). Ziprasidone only became a treatment option after 40% of patients had been enrolled, and individuals with tardive dyskinesia (TD) were not eligible for randomisation to perphenazine. Analyses of four different datasets were carried out to ensure that participants had equal chance of being randomised to each of the groups being compared: perphenazine versus the three SGAs available at the start of the study (excluded participants with TD and those receiving ziprasidone); the three SGAs available at the start of the study versus each other; perphenazine versus ziprasidone (excluded those with TD); …

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