A widely used class of antipsychotic drugs that includes bestsellers Zyprexa, Risperdal and Seroquel is just as likely -- perhaps even more likely -- to cause a fatal heart attack as older antipsychotic drugs like haloperidol, researchers reported today.
The findings, which run contrary to a long-standing belief, add to a growing drumbeat of criticism about this class of drugs, known as atypical antipsychotics. Zyprexa, Risperdal and Seroquel are among the 10 most commonly prescribed medications in the world, with annual sales estimated at $14.5 billion.
Researchers are especially concerned about the rising use of atypical antipsychotics in the elderly and the young -- both groups that are fragile and more susceptible to adverse effects of powerful medications.
Last week British researchers reported in the journal Lancet Neurology that Alzheimer's patients given the drugs to control aggression were nearly twice as likely to die from any cause as patients who did not receive them.
Some studies have shown that as many as 40% of Alzheimer's patients in nursing homes receive the drugs for unapproved use.
The number of prescriptions for the drugs written for children and adolescents doubled to 4.4 million from 2003 to 2006, in part because of increases in diagnoses of bipolar disorder. Their efficacy in children and Alzheimer's patients has never been demonstrated, experts said.
Eli Lilly & Co., the manufacturer of Zyprexa, is expected to settle a lawsuit with the federal government as early as today, paying a record $1.4 billion in civil and criminal charges to resolve complaints about the marketing of Zyprexa for unapproved uses. The company has already paid nearly $1.3 billion to states and consumers to settle other complaints about marketing and side effects.
"I am, and have been, very concerned about these drugs," said Dr. Ian Cook, a psychiatrist at UCLA's Geffen School of Medicine who was not involved in the new study. "These are powerful medications that affect the brain and the body, and we need to be very thoughtful in their use."
No one, however, is urging abandonment of the atypical antipsychotics. The nub of the matter is that there are no other drugs with the same beneficial effects.
"The antipsychotics are a godsend," said Dr. Alan Manevitz, a psychiatrist at Lenox Hill Hospital in New York who was not involved in the study. "They have taken people and unchained them from walls. . . . We don't want to throw out the baby with the bathwater."
