Patient Compliance with Drug Therapy in Schizophrenia

Lindström, Eva; Bingefors, Kerstin

doi:10.2165/00019053-200018020-00002

Cited by 92 publications

(78 citation statements)

References 163 publications

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“…17,46 However, with the increased use of the second-generation, atypical antipsychotics, akathisia has become less of an issue, 9,47 and indeed current thinking is that lack of efficacy, rather than tolerability profile, is a stronger predictor of early discontinuation. 7,35,[48][49][50] Medication noncompliance and undercompliance continue to be a problem in the treatment of schizophrenia; the vast majority of hospital admissions for exacerbation of psychosis have been linked to noncompliance, 6,51 which may still be the most important militating factor in relapse. 6 The correlations between patient attitude toward medication, treatment persistence, and symptom improvement in the present research do not suggest a causal relationship.…”

Section: Discussionmentioning

confidence: 99%

“…3 Nonadherence to treatment is associated with poorer clinical and functional outcomes, increased use of emergency psychiatric services, and an increased number of hospitalizations. 4,5 In fact, noncompliance is the leading contributor to relapse, 6,7 and the overwhelming majority of patients with schizophrenia who require hospitalization have generally been noncompliant in the period leading up to their most recent episode. 6 Conversely, longer duration of treatment is associated with reduced rates of relapse and hospitalization.…”

Section: Introductionmentioning

confidence: 99%

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Patient perspectives on antipsychotic treatments and their association with clinical outcomes

Liu‐Seifert

Osuntokun²,

Godfrey³

et al. 2010

PPA

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This analysis examined patient-reported attitudes toward antipsychotic medication and the relationship of these attitudes with clinical outcomes and pharmacotherapy adherence. The analysis included three randomized, double-blind studies in patients with schizophrenia, schizoaffective disorder, or schizophreniform disorder diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition and randomly assigned to treatment with olanzapine 5-20 mg/day or another antipsychotic (haloperidol 2-20 mg/day, risperidone 2-10 mg/day, or ziprasidone 80-160 mg/day). Patient-reported improvements were significantly greater for olanzapine (n = 488) versus other treatments (haloperidol n = 145, risperidone n = 158, or ziprasidone n = 271) on multiple Drug Attitude Inventory items. A positive attitude toward medication reported by patients was significantly associated with greater clinical improvement on the Positive and Negative Syndrome Scale and lower discontinuation rates. These results suggest that patients' perceptions of treatment benefits are associated with objective clinical measures, including reduction of symptom severity and lower discontinuation rates. Furthermore, olanzapine may be associated with more positive treatment attitudes. These findings may contribute to a better understanding of reasons for treatment adherence from patients' own perspectives.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient perspectives on antipsychotic treatments and their association with clinical outcomes

Liu‐Seifert

Osuntokun²,

Godfrey³

et al. 2010

PPA

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“…Schizophrenia has been estimated to have an annual incidence of between 2 and 4 per 10,000, with a prevalence 10 times that rate [2] . Schizophrenia is characterized by deficits in three symptom domains: positive, negative, and cognitive (see reference [3] for more details).…”

Section: Schizophreniamentioning

confidence: 99%

“…The economic impact of schizophrenia is large and growing rapidly -from an estimated $32.5 billion in 1990 [2] to $63 billion just 12 years later [4] . A Table 1 for concise summary) 9.…”

Section: Schizophreniamentioning

confidence: 99%

“…Safety and tolerability substantial portion of the cost of schizophrenia is due to indirect costs -resulting from increased mortality and morbidity, criminal behavior, use of social welfare programs, and family caregiving costs [5] . By some estimates, these indirect costs represent half or more of the economic cost of schizophrenia, with direct costs -money spent on drug treatment and hospitalizations, for example -accounting for the other half [2,5] .…”

Section: Schizophreniamentioning

confidence: 99%

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Pimavanserin tartrate: a 5-HT2A inverse agonist with potential for treating various neuropsychiatric disorders

Abbas¹,

Roth²

2008

Expert Opinion on Pharmacotherapy

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Background : Pimavanserin tartrate is the first 5-HT 2A inverse agonist to enter clinical trials as a treatment for L -dopa-induced psychosis in Parkinson's disease and for augmentation of low-dose risperidone treatment in schizophrenia. Pimavanserin is also being evaluated as a possible anti-insomnia drug. Objective : To discuss the potential of pimavanserin to fill multiple therapeutic needs. Methods : The problems with currently approved antipsychotics and sleep agents are explored to highlight how pimavanserin might address some longstanding issues in the treatment of psychosis and insomnia. Results/conclusions : In Phase II clinical trials, pimavanserin seemed to be safe, well-tolerated and efficacious in treating L -dopa-induced psychosis without worsening motor symptoms. Pimavanserin also potentiated the therapeutic effects of low-dose risperidone, reduced haloperidol-induced akathisia, and increased slow-wave sleep in older individuals.

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