From The Streets Of London With Malcolm Aitken
New Generation Anti-Psychotics Green Light In UK
A new generation of freely available better drugs to treat schizophrenia was augured in yesterday in Britain with the
announcement of new National Health Service prescription guidelines. Patient support groups have cautiously welcomed the
NHS’s effective adoption of more refined ‘atypical’ anti-psychotics as a norm. It represents ‘ the first gain in a long
battle to create a 21st century mental health service’ Cliff Prior, chief executive of the National Schizophrenia
Fellowship told Scoop.
Experts anticipate side effects such as spasms, trembling, and weight gain will become a thing of the past using these
advanced pharmaceuticals. And gone hopefully will be the blurred vision and dry mouths, fits and sexual dysfunction that
often result from ‘typical’ anti-psychotic drugs.
Cost effectiveness was cited by the NHS vetting body, the National Institute for Clinical Excellence (Nice) in
announcing the guidelines, which are binding on health care providers in England and Wales. Nice says significant extra
short-term costs will be incurred paying for the superior drugs: they cost an average of £1220 ($3660) per person per
year compared with £70 ($210) for the traditional pills. However, huge savings will accompany the £70 million ($210
million) additional cost to the NHS. More out patients will comply with doctors’ orders, as there’s a greater
willingness to take medicines without severe side effects. Hospital admissions will consequently decrease. A shift from
inpatient care to less expensive residential and community care will save the state hugely. Nice also considered
existing social costs such as possible violence when patients on schizophrenia drugs stop taking their medicine
following deleterious side effects.
Until now there has been wide variations in access to the atypical anti-psychotics because of concerns over their
effectiveness and cost. About £1billlion ($3billion), three percent of the NHS annual budget, is currently spent
directly on treating schizophrenia. According to schizophrenia fellowship figures, less than 20 percent of the 210 000
people who could benefit have access to the most modern medicines and 62 percent of people are denied a choice of
drug(s) by their clinician. The fellowship says the guidelines mark the finish of a 10-year battle to end rationing of
schizophrenia medicines.
‘At any time between two and 10 people out of every thousand in England and Wales are affected by schizophrenia,’ Nice
communications director Anne-Toni Rodgers told Scoop.
It is intended that people who are achieving good control of their illness through taking typical anti-psychotics such
as haloperidol and chlorpromazine without ‘unacceptable’ side effects will discuss whether it’s worth changing to the
new drugs with their clinicians. Some will retain their current treatment regime. The atypicals (amisulpride,
olanzapine, quetiapine, risperidone and zotepine) will generally be the first drugs given to people with newly diagnosed
schizophrenia.
Schizophrenia has a wide range of symptoms Nice told Scoop. ‘Hallucinations [often hearing voices], delusions [false
ideas that do not respond to reasoned argument], muddled speech and thoughts and flattening of one’s mood, resulting in
detachment and no strong emotions.’ Anti-psychotic pills work on neurotransmitters, which send messages between
different parts of the brain.
Mr Prior is pleased but emphatic mental health services aren’t put under more strain. He warned: ‘New rules mean that
budget holders must implement the Nice decision but without additional resources other mental health services could
suffer as funds are diverted.‘
‘From today, only the best will do. Second-class citizenship for people with severe mental illness is no longer an
option.'
ENDS