Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia

Abstract

The majority of patients in each group discontinued their assigned treatment owing to inefficacy or intolerable side effects or for other reasons. Olanzapine was the most effective in terms of the rates of discontinuation, and the efficacy of the conventional antipsychotic agent perphenazine appeared similar to that of quetiapine, risperidone, and ziprasidone. Olanzapine was associated with greater weight gain and increases in measures of glucose and lipid metabolism.

Sleep dysfunctions in schizophrenia: A practical review

“…[5,7]. The evidence also suggests that reduced sleep duration is more commonly reported in neuroleptic-naive or drug-free individuals, while a longer need for sleep is reported in medicated samples [4,8], consistent with drug studies demonstrating the sedative properties of antipsychotic medication. Investigations of circadian rhythm chronobiologic parameters in SZ also point to disruptions in the internal biological clock of patients, showing dysregulation of the suprachiasmatic nucleus (SCN) and abnormal levels of melatonin [9][10][11][12].…”

How Psychiatrists Recommend Treatment and Its Relationship with Patient Uptake

“…Indeed, in extract 3 the patient displays a high degree of entitlement to decline treatment – resisting, quite directly, and drawing on the possibility of side effects to support this resistance. The frequently enduring nature of anti-psychotic treatment, vulnerable to intolerable side effects, inefficacy (Lieberman et al, 2005), and divergent evaluations by patients (Hellewell, 2002) creates a domain in which patients may retain the ‘specialist’ knowledge. Given that psychiatrists’ informedness of such effects can only be derivative, i.e.…”

“…In the 18-month Clinical Antipsychotic Trials for Intervention Effectiveness (CATIE) study (Lieberman et al, 2005), a remarkable 74% of patients discontinued medication prematurely and the most common reasons for discontinuation were patient choice, lack of effect or intolerability of side effects. A great deal of attention has focused on methods to persuade patients to adhere to treatment decisions, without sufficient acknowledgement that avoidance of sometimes complex, costly, and unpleasant regimens may be entirely rational (Mitchell, 2007).…”

Schizophrenia: The drug deadlock

“…The Clinical Anti-psychotic Trials of Intervention Effectiveness (CATIE) made it clear that the new therapies were barely different from the old 1 . They were just as good as perphenazine at controlling psychosis -hallucinations and delusions.…”