Supplement: The Lessons of CATIE

When the results of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) were published in 2005, researchers presented clinicians with a surprise: Doctors had thought that second-generation, or atypical, antipsychotic medications were more effective, and produced fewer extrapyramidal side effects, such as tremors, rigidity, restlessness, and tardive dyskinesia, than their predecessors. However, the National Institute of Mental Health study found no significant difference between the generations in terms of efficacy, and only small differences in terms of side-effect profiles (NEJM, 353:1209-23, 2005).

For example, patients discontinued olanzapine, an atypical antipsychotic, and perphenazine, a typical antipsychotic, at the same rate due to...