Response and Relapse in Patients With Schizophrenia Treated With Olanzapine, Risperidone, Quetiapine, or Haloperidol

Dossenbach, M.; Arango-Dávila, César Augusto; Ibarra, Hernán Silva; Landa, Eric; Aguilar, Javier; Caro, Osvaldo; Leadbetter, Joanna; Assunção, Sheila Seleri Marques

doi:10.4088/jcp.v66n0810

Cited by 87 publications

(2 citation statements)

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“…[3][4][5] Antipsychotic medication is an effective treatment for schizophrenia. 6 Antipsychotics were found to be statistically significant indicators of quality of life. 7 Recently, treatments increasingly focus on improving the quality of life for patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 98%

The influence of adherence to antipsychotics medication on the quality of life among patients with schizophrenia in Indonesia

Endriyani

Chien

Huang

et al. 2018

Perspect Psychiatr Care

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Section: Introductionmentioning

confidence: 98%

The influence of adherence to antipsychotics medication on the quality of life among patients with schizophrenia in Indonesia

Endriyani

Chien

Huang

et al. 2018

Perspect Psychiatr Care

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“…SOHO was conducted in 10 Western European countries (EU-SOHO) [7,8], and in 27 countries across 4 continents as the Intercontinental SOHO (IC-SOHO) [9]. Data from all 37 participating countries were pooled to produce the Worldwide-SOHO (W-SOHO) dataset.…”

Section: Methodsmentioning

confidence: 99%

Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the worldwide schizophrenia outpatients health outcomes (W-SOHO) study

et al. 2012

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BackgroundWith many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting.MethodsW-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162) and vice versa (n=136). Clinical status was assessed at the visit when the first switch was made (i.e. before switching) and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH) overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization).Results48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019). Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26), extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89) and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13). No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who switched to olanzapine (difference of 0.29 points, p=0.013).ConclusionOur study showed that patients who switched from risperidone to olanzapine were likely to experience a more favorable treatment course than those who switched from olanzapine to risperidone. Given the nature of observational study design and small sample size, additional studies are warranted.

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Quetiapine versus other atypical antipsychotics for schizophrenia

Asmal

Flegar

Wang

et al. 2010

Cochrane Database of Systematic Reviews

122

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Background In many countries of the industrialised world second generation (’atypical’) antipsychotic drugs have become the first line drug treatment for people with schizophrenia. It is not clear how the effects of the various second generation antipsychotic drugs differ. Objectives To evaluate the effects of quetiapine compared with other second generation antipsychotic drugs for people with schizophrenia and schizophrenia-like psychosis. Search methods We searched the Cochrane Schizophrenia Group Trials Register (April 2007), inspected references of all identified studies, and contacted relevant pharmaceutical companies, drug approval agencies and authors of trials for additional information. Selection criteria We included all randomised control trials comparing oral quetiapine with oral forms of amisulpride, aripiprazole, clozapine, olanzapine, risperidone, sertindole, ziprasidone or zotepine in people with schizophrenia or schizophrenia-like psychosis. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random-effects model. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. For continuous data, we calculated weighted mean differences (WMD) again based on a random-effects model. Main results The review currently includes 21 randomised control trials (RCTs) with 4101 participants. These trials provided data on four comparisons - quetiapine versus clozapine, olanzapine, risperidone or ziprasidone. A major limitation to all findings is the high number of participants leaving studies prematurely (57.6%) and the substantial risk of biases in studies. Efficacy data favoured olanzapine and risperidone compared with quetiapine (PANSS total score versus olanzapine:10 RCTs, n=1449, WMD 3.66 CI 1.93 to 5.39; versus risperidone: 9 RCTs, n=1953, WMD 3.09 CI 1.01 to 5.16), but clinical meaning is unclear. There were no clear mental state differences when quetiapine was compared with clozapine or ziprasidone. Compared with olanzapine, quetiapine produced slightly fewer movement disorders (6 RCTs, n=1090, RR use of antiparkinson medication 0.49 CI 0.3 to 0.79, NNH 25 CI 14 to 100) and less weight gain (7 RCTs, n=1173, WMD −2.81 CI −4.38 to −1.24) and glucose elevation, but more QTc prolongation (3 RCTs, n=643, WMD 4.81 CI 0.34 to 9.28). Compared with risperidone, quetiapine induced slightly fewer movement disorders (6 RCTs, n=1715, RR use of antiparkinson medication 0.5 CI 0.3 to 0.86, NNH 20 CI 10 to 100), less prolactin increase (6 RCTs, n=1731, WMD −35.28 CI −44.36 to −26.19) and some related adverse effects, but more cholesterol increase (5 RCTs, n=1433, WMD 8.61 CI 4.66 to 12.56). Compared with ziprasidone, quetiapine induced slightly fewer extrapyramidal adverse effects (1 RCT, n=522, RR use of antiparkinson medication 0.43 CI 0.2 to 0.93, NNH not estimable) and prolactin increase. On the other hand quetiapine was more sedating and led to mor...

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Response and Relapse in Patients With Schizophrenia Treated With Olanzapine, Risperidone, Quetiapine, or Haloperidol

Cited by 87 publications

References 0 publications

The influence of adherence to antipsychotics medication on the quality of life among patients with schizophrenia in Indonesia

The influence of adherence to antipsychotics medication on the quality of life among patients with schizophrenia in Indonesia

Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the worldwide schizophrenia outpatients health outcomes (W-SOHO) study

Quetiapine versus other atypical antipsychotics for schizophrenia

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