Letter
CATIE Findings Revisited
To the Editor: We applaud the special section in the May 2008 issue with commentaries interpreting findings from the landmark Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study ( 1 , 2 ). The introduction stated that "the literature suggests little evidence that, with the exception of clozapine, second-generation antipsychotics confer superior efficacy in ameliorating positive and negative symptoms and improving cognition or that they are more tolerable." Our meta-analysis ( 3 ) is one of ten published reports cited at the end of this statement.
For the record, like the animals in Animal Farm, some second-generation antipsychotics—olanzapine, risperidone, and amisulpride—were shown in our analysis to be superior to first-generation antipsychotics. In addition, the report by Lieberman and colleagues ( 4 ) of results from phase I of CATIE showed that olanzapine was superior in efficacy to the first-generation antipsychotic perphenazine. We agree that clozapine is more effective than first-generation antipsychotics and that given the data currently available, the other second-generation antipsychotics—quetiapine, ziprasidone, and aripiprazole—have not been shown to have better efficacy than first-generation agents.
1. Swartz MS: Introduction to the CATIE special section. Psychiatric Services 59: 497–499, 2008.Google Scholar
2. Swartz MS, Stroup TS, McEvoy JP, et al: What CATIE found: results from the schizophrenia trial. Psychiatric Services 59:500–506, 2008Google Scholar
3. Davis JM, Chen N, Glick ID: A meta-analysis of the efficacy of second-generation antipsychotics. Archives of General Psychiatry 60:553–564, 2003.Google Scholar
4. Lieberman JA, Stroup TS, McEvoy JP, et al: Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. NEJM 353:1209–1223, 2005Google Scholar