Early Prediction of Clinical Response in Schizophrenia Patients Receiving the Atypical Antipsychotic Zotepine

Lin, Ching‐Hua; Chou, Li-Shiu; Lin, Chih‐Lang; Hsu, Chen‐Chin; Chen, Yong-Shing; Lane, Hsien‐Yuan

doi:10.4088/jcp.v68n1008

Cited by 36 publications

(25 citation statements)

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“…Finally, the ROC approach is non-parametric, highly sensitive to possible interactions, and imposes no assumptions about normality, equal variances, or linear associations, making it more widely applicable than classic linear models (Kiernan, Kraemer, Winkleby, King, & Taylor, 2001). The use of ROCs to examine predictors and moderators of response to psychiatric treatments has become common in the past 10 years, with dozens of studies employing this approach (e.g., Hallinan, Ray, Byrne, Agho, & Attia, 2006; Jager et al, 2009; Kemp, Johnson, Wang, Tohen, & Calabrese, 2011; Lin et al, 2007). …”

Section: The Roc Approachmentioning

confidence: 99%

Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type

Owens

Hinshaw

McBurnett

et al. 2016

Journal of Clinical Child & Adolescent Psychology

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Objective: To examine baseline characteristics – child gender, IQ, age, internalizing problems, symptoms of hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), and sluggish cognitive tempo, and parent income, education, attention deficit/hyperactivity disorder (ADHD) severity, and anxiety/depression (A/D) -- associated with response to behavioral treatments for ADHD, predominantly inattentive type. Method: We employed data from 148 children (M = 8.7 years), 58% male, and 57% Caucasian in a randomized clinical trial. Positive treatment response was defined as (a) five or fewer inattentive symptoms, and (b) a decrease of at least three inattentive symptoms from baseline to post-treatment. Results: Child HI, parental A/D, and child IQ were associated with positive response, as follows: Child HI had a main effect in which it was negatively associated with treatment response (36% with two or more HI symptoms were positive responders versus 59% of those with one or fewer symptom) that was qualified by parental A/D and child IQ. When children had two or more symptoms of HI and higher parental A/D, positive response rate was low 25%; when children had two or more symptoms of HI, low parental A/D, and an IQ of 105 or more, positive response rate was 85%. Furthermore, the group with the poorest response rate (25%) had parents who self-reported greater ADHD severity, and the group with a relatively good rate of positive response (59%) had the lowest number of ODD symptoms. Conclusion: Likelihood of positive response to our behavioral treatment for ADHD-I is dependent on child and parent factors.

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Section: The Roc Approachmentioning

confidence: 99%

Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type

Owens

Hinshaw

McBurnett

et al. 2016

Journal of Clinical Child & Adolescent Psychology

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“…Studies with multi-episode patients have demonstrated the utility of using limited improvement early in treatment to identify subjects who will not respond to a longer trial of antipsychotics 11–17. Unfortunately, our data suggest that with a first episode population these methods do not classify subjects with enough accuracy to be clinically useful.…”

Section: Discussionmentioning

confidence: 75%

“…Studies with multi-episode patients have successfully used percent reduction in BPRS or PANSS scores from baseline after a few weeks of treatment to predict treatment response or non-response at study completion11–17. The SADS-C+PD has detailed assessments of psychotic symptoms, but also of several other symptom domains not included in the BPRS or PANSS.…”

Section: Methodsmentioning

confidence: 99%

“…We also wished to address a related clinical question arising from treatment trials lasting several months. Studies with multi-episode patients 11–17 have suggested that response patterns early in treatment can identify patients who are not likely to respond to a treatment with a particular medication. If similar methods are also valid with first episode patients, then those patients who will not respond to a treatment could be spared from being exposed to an ineffective treatment for several months.…”

Section: Introductionmentioning

confidence: 99%

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Time to Treatment Response in First-Episode Schizophrenia

Gallego¹,

Robinson²,

Sevy³

et al. 2011

J. Clin. Psychiatry

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Objectives-Response patterns may differ between patients with first episode and multi-episode schizophrenia. This analysis explored trial duration with first episode patients and whether early limited improvement predicts ultimate lack of treatment response with first episode patients as it does with multi-episode patients.Methods-112 subjects (mean age=23.3 years [SD=5.1]) who presented between November 1998 and October 2004 with a first episode of psychosis and had a DSM-IV diagnosis of schizophrenia, schizophreniform or schizoaffective disorder, were randomly assigned to treatment with olanzapine or risperidone for 16 weeks. Treatment response, the primary outcome measure, was defined as a rating of mild or better on all of the positive symptom items on the SADS-C + PD. Response rates were calculated for each study week. A logistic regression analysis examined the association between percent reduction in symptom severity scores from baseline values at weeks 2, 4 or 8 and response by week 16.Results-The estimated cumulative response rate by week 8 was 39.59% (95% CI: 29.77% -49.41%) and 65.19% (95% CI: 55.11% -75.27%) by week 16. The confidence intervals for estimated response at weeks 10, 12, 14 and 16 were not distinct. Response rates increased approximately 5 to 6 percentage points each 2 week interval between week 10 and 16. Percent reduction in symptom severity score at week 4 (but not 2 or 8) was associated (Chi-square = 3.96; df = 1, p<0.05) with responder status at week 16 (odds ratio: 1.03; 95% CI: 1.00;1.05). However, Disclosures:Dr. Robinson has received research support from Lilly, Janssen, and Bristol-Myers Squibb. Dr. John Kane serves as a Consultant and/ or Advisory Board member for BMS, Otsuka, Lilly, Janssen, Pfizer, Wyeth, Vanda, GSK, Lundbeck, J & J, PGX Healthcare, Proteus, a shareholder of MedAvante, and serves on Speaker's Bureau for BMS, Janssen, Astra Zeneca, and Lilly. Dr. Sevy has served as a consultant for Abbott laboratories. Dr. Gallego, Ms. McCormack, and Dr. Lesser report no competing interests. Ms. Napolitano had no competing interests when she performed her work reported in the manuscript. Dr. Woerner, Dr. Gunduz-Bruce, Dr. Patel and Ms. Miller report no competing interest. Dr. Schooler has been a consultant for Hoffman La Roche and Lundbeck and has received grant support from Astra-Zeneca, Janssen, Pfizer, Lilly, Novartis and BMS. She has been a speaker or has been an advisory board member for Abbot, Lilly, Roche, Janssen, Lundbeck and Merck.

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“…Clinicians could identify early non-responder and rapidly switch to a potentially more effective treatment strategy. The duration of hospitalization, illness burden and costs with it could be reduced 17. Recently, there has been some studies distinguishing responders in acute phase from non-responders (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Influencing Factors and Predictors of Early Response in Schizophrenia Patients Receiving the Paliperidone Extended-Release Tablets (Paliperidone ER)

Jung

Yoon

Ahn

et al. 2013

Psychiatry Investig

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ObjectivePaliperidone extended-release tablet (paliperidone ER) is a new oral psychotropic agent developed for schizophrenia treatment. There have been some studies about paliperidone's good efficacy and tolerability. Clinicians appear to change the antipsychotic medication to paliperidone ER. However, it is not known what patients are favorable responsive to paliperidone ER. The aim of this study was to evaluate the characteristics of early responders and investigate predictors of acute response when the medications changed to paliperidone ER.MethodsData were analyzed from schizophrenic patients who participated in a multi-center, open-label, non-comparative clinical trial. Total 320 patients were examined in this study. Sociodemographic, psychopathology, social function and metabolic data were evaluated. Unpaired t-test for continuous and χ2 for categorical data, respectively, were used to compare early responder and non-responders. Logistic regression analysis was used to establish a prediction model.Results38.7% of study subjects (124 of 320) responded to paliperidone ER treatment. Logistic regression analysis showed that a good paliperidone ER response was more likely when patients were social drinkers, when patients had started medication at inpatient, when negative symptoms were less severe, and when patients' social relationship and self-care were better.ConclusionEarly response to paliperidone ER treatment is associated with less negative symptoms and good social relationships and self-care. Strategies to reduce these symptoms may contribute to early response to paliperidone ER.

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Early Prediction of Clinical Response in Schizophrenia Patients Receiving the Atypical Antipsychotic Zotepine

Cited by 36 publications

References 0 publications

Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type

Predictors of Response to Behavioral Treatments Among Children With ADHD-Inattentive Type

Time to Treatment Response in First-Episode Schizophrenia

Influencing Factors and Predictors of Early Response in Schizophrenia Patients Receiving the Paliperidone Extended-Release Tablets (Paliperidone ER)

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