Atypical antipsychotics-designed to treat schizophrenia and bipolar disorder (manic-depression)-were introduced in 1990, and were heralded by the drug companies as being more effective and safer than the standard antipsychotics.
As a result, drugs such as Seroquel, Zyprexa, Risperdal and Geodon have become the first-line treatment for many psychotic disorders, generating around $10.5bn a year in sales for the manufacturers.
But a major study-the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)-has revealed that the atypicals are no more effective than the older antipsychotics and, yet, they cost around 30 per cent more.
And the atypicals are not safer drugs either. So far, Eli Lilly, which makes Zyprexa, has signed a settle-ment of $690m that is being paid to 8000 plaintiffs who have claimed that the drug was the cause of their diabetes.
So, how did Lilly get its product approved in the first place? There are stories swirling around that American government officials received a pay-off from the manufacturer, and that safety records were suppressed.
What we do know for sure is that the drug companies have been the only winners in a gambit that has brought in more than $100bn from sales of the atypicals (Am J Psychiatry, 2006; 163: 2080-9).