Clinical and economic impact of newer versus older antipsychotic medications in a community mental health center.

Journal Article (Clinical Trial;Journal Article)

This pilot study was conducted to compare both the clinical effectiveness and the treatment costs of newer (atypical) antipsychotic medications (clozapine and risperidone) with those of older (classic) neuroleptic medications (chlorpromazine and haloperidol) for psychosis in a community mental health care setting. The study used a retrospective, uncontrolled, open, nonrandomized, within-subjects design and relied on medical records as a data source for 37 clients. All clients received older antipsychotics for at least 1 year, newer antipsychotics for a transition period of 3 months, and the newer agents for at least an additional year. The newer antipsychotic medications were more effective and less costly (total cost of care, $3000 less per client per year [1997 dollars]) than the older medications. Effect-size estimates for the measured variables provide a guide for future research into the cost-effectiveness of these newer medications within the community mental health care setting. These findings can provide policy makers with guidance on treating people with major mental disorders in the most effective and efficient manner. Because of limited budgets, community mental health centers making the investment in newer, more expensive medications to improve client outcomes have to maintain the same or lower total cost of care. Results of the current study suggest that short-term investment in the newer medications by community mental health centers offers superior clinical effectiveness and lower long-term overall cost of care.

Full Text

Duke Authors

Cited Authors

  • Galvin, PM; Knezek, LD; Rush, AJ; Toprac, MG; Johnson, B

Published Date

  • June 1999

Published In

Volume / Issue

  • 21 / 6

Start / End Page

  • 1105 - 1116

PubMed ID

  • 10440630

International Standard Serial Number (ISSN)

  • 0149-2918

Digital Object Identifier (DOI)

  • 10.1016/s0149-2918(99)80028-9


  • eng

Conference Location

  • United States