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The British Journal of Psychiatry (2006) 189: 391-392. doi: 10.1192/bjp.bp.106.029983
© 2006 The Royal College of Psychiatrists
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EDITORIAL

The schizophrenia drug-treatment paradox: pharmacological treatment based on best possible evidence may be hardest to practise in high-income countries{dagger}

CLIVE E. ADAMS

University of Leeds, Leeds, UK

PRATHAP THARYAN

Christian Medical College, Vellore, India

EVANDRO S. F. COUTINHO

Ozwaldo Cruz Foundation, Rio de Janeiro, Brazil

T. SCOTT STROUP

University of North Carolina, Carolina, Chapel Hill, North Carolina, USA

Correspondence: Professor Clive E. Adams, Co-ordinating Editor, Cochrane Schizophrenia Group, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, UK. Tel: +44 (0)113 343 1965; fax: +44 (0)113 343 2723; email: ceadams{at}cochrane-sz.org

Declaration of interest T.S.S. has consulted for Janssen and consulted and spoken for Lilly and Pfizer; he is a principal investigator in a Schizophrenia Trials Network, sponsored by the National Institute of Mental Health, aiming to undertake pragmatic randomised trials.

See pp. 433–440, this issue.

Most people with schizophrenia live in low- and middle-income countries in which clinicians/policy makers are not the first targets of marketing. Because it is years after a drug is first launched that the full effects become known with confidence, the evidence upon which to base practice in low- and middle-income countries may be less biased than that in richer nations.


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