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ESI Special Topics, January 2006
Citing URL: http://www.esi-topics.com/fmf/2006/january06-JohnGeddes.html

From •>>January 2006

John Geddes answers a few questions about this month's fast moving front in the field of Psychiatry/Psychology.

Field: Psychiatry/Psychology
Article: Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis
Authors: Geddes, J;Freemantle, N;Harrison, P;Bebbington, P;Natl Schizophrenia Guideline Dev
Journal: BRIT MED J, 321 (7273): 1371-1376, DEC 2 2000
Addresses: Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford OX3 7JX, England.
Univ Oxford, Warneford Hosp, Dept Psychiat, Oxford OX3 7JX, England.
Univ York, Ctr Hlth Econ, Med Evaluat Grp, York YO10 5DD, N Yorkshire, England.
Royal Free & Univ Coll Med Sch, Dept Psychiat & Behav Sci, London W1N 8AA, England.


   Why do you think your paper is highly cited?

Our findings were controversial but highlighted the level of uncertainty about the relative benefits and costs of the new antipsychotics.

   Does it describe a new discovery or a new methodology that's useful to others?

It’s a review paper—but the use of meta-regression was relatively new in psychiatry.

   Could you summarize the significance of your paper in layman's terms?

We reviewed the randomized trials comparing newer and older antipsychotic drugs and found that there was no clear advantage to the new drugs. A recently published large NIMH-funded study—"Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia," by J. A. Lieberman, et al, for the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) investigators, New England Journal of Medicine, Volume 353:1209-1223, September 22, 2005, No.12—essentially confirmed our findings.

   How did you become involved in this research, and were there successes or failures along the way?

We were looking into the application of formal clinical practice guideline development in psychiatry and chose the new antipsychotic drugs as a priority area. Our results met with a lot of opposition and did not really affect practice! However, they did contribute to the Equipoise case needed to undertake CATIE and other such trials

   If applicable, what are the social or political implications of your research?

Never underestimate the difficulties of implementing evidence-based decision making!End

John Geddes, M.D. FRCPsych
Centre for Evidence Based Mental Health
Department of Psychiatry
University of Oxford
Warneford Hospital
Oxford U.K.

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ESI Special Topics, January 2006
Citing URL: http://www.esi-topics.com/fmf/2006/january06-JohnGeddes.html
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