The Rational Use of Antipsychotics in Malaysia - A Rethinking Following the Catie Studies

Most studies favour the use of novel or atypical antipsychotics over the conventional typical antipsychotics in the treatment of schizophrenia. Unfortunately, the atypicals are very expensive to use and beyond the financial means of the average Malaysian. Unlike developed countries where mental disorders are covered by health insurance and hospitalisation schemes, in Malaysia, mental disorders including schizophrenia, are discriminated by insurance companies and are included in their exclusion clauses as disorders not for insurance coverage. Following the publication of the CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) studies in 2005 (phase 1) and 2006 (phase 2), which suggested that typical antipsychotics are just as effective as atypicals and not significantly more likely to cause side-effects including neurological symptoms, it is suggested that a rethinking or reassessment of the vigorous use of atypicals be considered.