Things were bound to get ugly. The total market for antipsychotics is $10 billion, there are five very similar atypicals jockeying for an extra nibble of that huge pie, and each atypical is backed by an aggressive pharmaceutical firm. You do the math.

If you who have chosen to spend inordinate amounts of your precious time reading these pages over the last year, you will remember the February 2003 (TCR, 1:2) issue in which TCR slammed Zyprexa for causing diabetes. Well, we're going to slam Zyprexa again this year, but not quite as viciously.

Topics: Antipsychotics

Tired of industry-funded antipsychotic trials? The NIMH comes to the rescue with the "CATIE" project (Clinical Antipsychotic Trials of Intervention Effectiveness). Blissfully un-industry-funded researchers have enrolled 1500 schizophrenic patients at 50 different sites, and have randomly assigned them to Zyprexa, Seroquel, Risperdal, Geodon, or Trilafon (perphenazine).

Dr. Buse, as an endocrinologist with a specialty in diabetes, I'm hoping you can help educate both myself and my psychiatrist readers about diabetes and antipsychotics. To begin with, we've been hearing a lot lately about the "metabolic syndrome." What is it?

Raymond Cavanaugh, M.D., is a psychiatrist in private practice in Lawrence and Lynn, Massachusetts, and has an interesting take on the differences between the atypicals.