Newer antipsychotic drugs come with their own new side effects

University of North Carolina professors hope their research into the positive and negative effects of such drugs will benefit teenagers with schizophrenia.

Brandon Constantineau, 18, of Wilmington, suffered severe mental illness as early as elementary school. Then, he started experiencing regular hallucinations.

"I had this friend in school who wasn't even real," Constantineau said.

His mother, Darlene Wilson, said she began to realize that more was going on than an over-active imagination.

"Sometimes, he would hear voices that weren't there or see things that weren't there," Wilson said.

That problem, along with extreme mood swings and emotional outbursts, got worse as Constantineau grew older. He was 15 when Dr. Lin Sikich, a psychiatrist with UNC, diagnosed him as suffering from  schizophrenia.

Constantineau joined a study to compare two newer drugs – Zyprexa, or olanzapine, and Risperdal, or risperidone – with an older one – Moban, or molindone.

All of the medications limit the amount of dopamine in the brain, which causes the psychotic symptoms.

"There wasn't a clear frontline drug to use," Sikich said. "All the drugs worked about equally well."

Constantineau was randomly assigned to Zyprexa. That drug and Risperdal caused him and other young patients to gain weight at an alarming rate.

"In a few short months, he had gained almost 35 pounds," Wilson said.

"It affected me greatly, because the kids were starting to notice I was gaining weight. I was getting picked on," Constantineau said.

Long term, that weight gain could cause life-threatening problems, such as heart disease and diabetes. In many patients, it can also exacerbate feelings of depression.

Sikich took Constantineau out of the study and changed his prescription. He takes Geodon, another newer-line drug, and glucophage, a diabetic drug used to control weight.

Constantineau said those drugs are helping him to better enjoy life with friends and family and to function at school.

"The medicine I'm on currently helps me out. It keeps the balance," Constantineau said.

Newer antipsychotic drugs do a good job at controlling symptoms, such as hallucinations, delusions and paranoia, but are less effective in dealing with apathy and problem-solving ability.

"The medicines do help, but we have to be really careful about the side effects," Sikich said.