Effectiveness of Antipsychotic Drugs in Patients With Chronic Schizophrenia: Efficacy, Safety, and Cost Outcomes of CATIE and Other Trials

After the introduction of clozapine in 1990,second-generation—or atypical—antipsychotics were thought to be more effective,safer, and less costly than first-generation—or typical—antipsychotics.However, only limited evidence on the efficacy and safety of atypicals wasavailable. Because of this knowledge gap, the National Institute of MentalHealth sponsored the Clinical Antipsychotic Trials of InterventionEffectiveness (CATIE) to compare first- and second-generation antipsychotics.The CATIE trial found that antipsychotic drug treatments are generallyeffective overall but have various limitations as reflected by high rates ofdiscontinuation due to both efficacy and tolerability problems. In addition,the trial found that conventional agents with intermediate potency werecomparably effective with atypical agents.