112. Effects of Ziprasidone Versus Placebo in Patients at Clinical High Risk for Psychosis

Woods, Scott W.; Saksa, John R.; Compton, Michael T.; Daley, Melita; Rajarethinam, Rajaprabhakaran; Graham, Karen; Breitborde, Nicholas J. K.; Cahill, John D.; Srihari, Vinod; Perkins, Diana O.; Bearden, Carrie E.; Cannon, Tyrone D.; Walker, Elaine F.; McGlashan, Thomas H.

doi:10.1093/schbul/sbx021.150

Cited by 23 publications

(20 citation statements)

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“…Only two studies had an overall low risk of bias; five had unclear risk, and nine had high risk. The edges (lines) in Figure reflect the Cochrane risk of bias for the blinding of outcome assessments, estimated as the level of bias in the majority of trials and weighted according to the number of studies in each comparison.…”

Section: Resultsmentioning

confidence: 99%

Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis

et al. 2018

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Preventing psychosis in patients at clinical high risk may be a promising avenue for pre-emptively ameliorating outcomes of the most severe psychiatric disorder. However, information on how each preventive intervention fares against other currently available treatment options remains unavailable. The aim of the current study was to quantify the consistency and magnitude of effects of specific preventive interventions for psychosis, comparing different treatments in a network meta-analysis. PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, and unpublished/grey literature were searched up to July 18, 2017, to identify randomized controlled trials conducted in individuals at clinical high risk for psychosis, comparing different types of intervention and reporting transition to psychosis. Two reviewers independently extracted data. Data were synthesized using network meta-analyses. The primary outcome was transition to psychosis at different time points and the secondary outcome was treatment acceptability (dropout due to any cause). Effect sizes were reported as odds ratios and 95% confidence intervals (CIs). Sixteen studies (2,035 patients, 57% male, mean age 20.1 years) reported on risk of transition. The treatments tested were needs-based interventions (NBI); omega-3 + NBI; ziprasidone + NBI; olanzapine + NBI; aripiprazole + NBI; integrated psychological interventions; family therapy + NBI; D-serine + NBI; cognitive behavioural therapy, French & Morrison protocol (CBT-F) + NBI; CBT-F + risperidone + NBI; and cognitive behavioural therapy, van der Gaag protocol (CBT-V) + CBT-F + NBI. The network meta-analysis showed no evidence of significantly superior efficacy of any one intervention over the others at 6 and 12 months (insufficient data were available after 12 months). Similarly, there was no evidence for intervention differences in acceptability at either time point. Tests for inconsistency were non-significant and sensitivity analyses controlling for different clustering of interventions and biases did not materially affect the interpretation of the results. In summary, this study indicates that, to date, there is no evidence that any specific intervention is particularly effective over the others in preventing transition to psychosis. Further experimental research is needed.

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Section: Resultsmentioning

confidence: 99%

Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis

et al. 2018

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“…The mean treatment duration was 30.0 weeks (range = 4‐104 weeks.). Interventions included: CRT ( N = 6) (Choi et al, ; Hooker et al, ; Loewy et al, ; Piskulic, Barbato, & Addington, ; Rauchensteiner et al, ; Urben, Pihet, Jaugey, Halfon, & Holzer, ), family‐based treatments ( N = 5) (Grano et al, ; Landa et al, ; McFarlane et al, ; Miklowitz Dj et al, ; O'Brien et al, ), CBT ( N = 6) (Addington et al, ; Kim et al, ; Morrison Ap et al, ; Morrison et al, ; Stain et al, ; van der Gaag et al, ), aripiprazole ( N = 3) (Kobayashi et al, ; Liu et al, ; Woods et al, ), NMDAR modulators ( N = 3) (Kantrowitz et al, ; Woods et al, ), omega‐3 ( N = 3) (Amminger et al, ; Cadenhead et al, ; McGorry et al, ), integrated psychological intervention ( N = 3) (Albert et al, ; Nordentoft et al, ; Wessels et al, ), risperidone plus CBT ( N = 2) (McGorry et al, ; McGorry Pd et al, ), amisulpride ( N = 1) (Ruhrmann et al, ), olanzapine ( N = 1) (McGlashan Th et al, ), low‐dose lithium ( N = 1) (Berger et al, ), ziprasidone ( N = 1) (Woods et al, ), perospirone ( N = 1) (Tsujino et al, ), second generation anti‐psychotics ( N = 1) (Cornblatt et al, ), anti‐psychotics not specified ( N = 3) (Morita et al, ; Shim et al, ; Walker et al, ) and heart rate variability biofeedback training ( N = 1) (McAusland & Addington, ). The control conditions varied as well; placebo ( N = 8), computer games ( N = 4), needs‐based interventions ( N = 12), supportive therapy ( N = 3) and enhanced care ( N = 1).…”

Section: Resultsmentioning

confidence: 99%

Attenuated psychotic symptom interventions in youth at risk of psychosis: A systematic review and meta‐analysis

Devoe

Farris

Townes

et al. 2018

Early Intervention Psych

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“…Results of two RCTs comparing N-methyl-D-aspartate receptor modulators (D-serine or glycine) to placebo reported that there no effect of glycine on any measure 59 , however, the use of D-serine study demonstrated a significant improvement in negative symptoms compared to placebo 60 . Mixed results have emerged from trials of antipsychotics both with and without psychosocial treatments [61][62][63][64][65] . Generally antipsychotics failed to reduce transition but did improve APS.…”

Section: Treatmentmentioning

confidence: 99%

Progression from being at-risk to psychosis: next steps

et al. 2020

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Over the past 20 years there has been a great deal of research into those considered to be at risk for developing psychosis. Much has been learned and studies have been encouraging. The aim of this paper is to offer an update of the current status of research on risk for psychosis, and what the next steps might be in examining the progression from CHR to psychosis. Advances have been made in accurate prediction, yet there are some methodological issues in ascertainment, diagnosis, the use of data-driven selection methods and lack of external validation. Although there have been several high-quality treatment trials the heterogeneity of this clinical high-risk population has to be addressed so that their treatment needs can be properly met. Recommendations for the future include more collaborative research programmes, and ensuring they are accessible and harmonized with respect to criteria and outcomes so that the field can continue to move forward with the development of large collaborative consortiums as well as increased funding for multisite projects.

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112. Effects of Ziprasidone Versus Placebo in Patients at Clinical High Risk for Psychosis

Cited by 23 publications

References 0 publications

Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis

Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis

Attenuated psychotic symptom interventions in youth at risk of psychosis: A systematic review and meta‐analysis

Progression from being at-risk to psychosis: next steps

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