Published: 20/06/2002, Volume II2, No.5810 Page 25
The comments of some of the academics in your report on the NICE decision regarding atypical anti-psychotics are extraordinary. To say that there is no evidence on which to base firm conclusions beggars belief (news page 4, 7 June). NICE has not ruled in favour of atypicals because of their greater efficacy in controlling symptoms, except for clozapine, although its report highlights that all evidence points to efficacy at least as good as the older drugs. The ruling is based on the reduced side-effects and greater likelihood that people will take the newer medicines, and for this the evidence is overwhelming.
Before its submission to NICE, the national service framework teamed up with Mind and the Manic Depression Fellowship to conduct the largest-ever survey of people's experiences of these medications. Most favoured the newer medications, which were linked to higher levels of being offered choice and information, and to lower levels of giving up without doctor's advice.
But few found the side-effect profile of the older drugs preferable. That is why our evidence pointed to informed choice as the ideal basis for prescribing. Informed choice is what NICE has ruled for, with atypicals to be favoured if the person cannot exercise choice, such as during an acute episode.
Schizophrenia is a disabling and distressing condition, with 10 per cent of people taking their own lives. Traditional treatments have added adverse effects of rigor, tremors, spasms, impotence and more, adding to the stigma of the condition.
It is time to end the idea that people with schizophrenia should 'put up' with treatment failures and disabling side-effects. The ruling by NICE is groundbreaking, putting the user at the heart of healthcare decisionmaking. It should be welcomed, implemented and funded.
For a free pack on exercising choice, call 020-8547 9221.
Cliff Prior Chief executive National Schizophrenia Fellowship