Risk of discontinuation of atypical antipsychotic agents in the treatment of schizophrenia

Mullins, C. Daniel; Obeidat, Nour A.; Cuffel, Brian J.; Naradzay, John; Loebel, Antony

doi:10.1016/j.schres.2007.04.035

Cited by 65 publications

(65 citation statements)

References 23 publications

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“…33 Much greater 26week discontinuation rates (78%-83%) were observed in a health care claims database analysis of atypical antipsychotic medication use. 34 Limitations of this extension study include the open label design (which may bias in favor of the investigational treatment) and the lack of an active control arm (eg, patients who continued on olanzapine). In addition, although any openlabel extension study has potential for selection bias, 254 of the 298 patients (85.2%) who completed the preceding doubleblind study elected to continue in the openlabel extension.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Lurasidone for Patients With Schizophrenia Following 6 Weeks of Acute Treatment With Lurasidone, Olanzapine, or Placebo

Stahl¹,

Cucchiaro²,

Simonelli³

et al. 2013

J. Clin. Psychiatry

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Objective:The primary objective was to evaluate the safety and tolerability of lurasidone, a new atypical antipsychotic agent, in the longer-term treatment of schizophrenia (DSM-IV). Persistence of symptom improvement was assessed as a secondary outcome. Method:Patients who completed a 6-week, doubleblind, placebo-controlled study evaluating the efficacy of fixed doses of once-daily lurasidone (40 or 120 mg) or olanzapine 15 mg (to confirm assay sensitivity) were eligible to receive flexibly dosed lurasidone 40 to 120 mg/d in this 6-month, open-label extension study During the open-label study (month 6 observed cases), small decreases were observed in mean weight (−0.1 kg) and median lipid levels (total cholesterol, −6.5 mg/dL; lowdensity lipoprotein, 0.0 mg/dL; high-density lipoprotein, 0.0 mg/dL; triglycerides, −8.5 mg/dL). Patients previously treated with olanzapine (n = 69) experienced decrease in weight and improvement in lipid levels, whereas patients previously treated with lurasidone (n = 115) or placebo (n = 62) experienced minimal changes. No clinically meaningful changes were observed in median prolactin levels. The 2 most commonly reported adverse events were akathisia (13.0%) and insomnia (11.0%). Persistent antipsychotic efficacy of lurasidone was shown for patients who had previously received lurasidone, olanzapine, or placebo; further reductions from open-label baseline to final visit were observed in mean PANSS total score (−8.7) for all patients. Conclusions:Open-label treatment with flexibly dosed lurasidone (40-120 mg/d) was generally safe, well tolerated, and effective over a 6-month period in patients who had completed a preceding 6-week, double-blind study.Trial Registration: ClinicalTrials.gov identifier: NCT00615433 Clin Psychiatry 2013;74(5):507-515 J

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Lurasidone for Patients With Schizophrenia Following 6 Weeks of Acute Treatment With Lurasidone, Olanzapine, or Placebo

Stahl¹,

Cucchiaro²,

Simonelli³

et al. 2013

J. Clin. Psychiatry

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“…The discontinuation date for LAI antipsychotics was set to the date for the next scheduled injection. In line with other studies, temporary breaks in antipsychotic treatment for up to 2 weeks were not regarded as discontinuations [Mullins et al 2008 Methodology, 2008]. The doses of the LAI antipsychotics were converted to daily doses by dividing the injected dose with the inter-injection time interval (days).…”

Section: Variablesmentioning

confidence: 99%

Time to discontinuation of antipsychotic drugs in a schizophrenia cohort: influence of current treatment strategies

Kroken

Kjelby

Wentzel‐Larsen

et al. 2014

Therapeutic Advances in Psychopharmacology

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Background: Rates of discontinuation of antipsychotic treatment for patients with schizophrenia are high and evidence is limited by selective inclusion and high attrition in randomized controlled trials. Aims: To study time to discontinuation of antipsychotic treatment for patients with schizophrenia. Method: All patients with schizophrenia (n = 396) discharged between 2005 and 2011 were followed until discontinuation (clinician or patient decided) of antipsychotic treatment or other endpoints. Univariate and multivariate survival analyses (with time on antipsychotic treatment as the dependent variable) using time-dependent variables were performed. Results: Clozapine displayed lower risk for all-cause (p < 0.001), clinician-decided (p = 0.012) and patient-decided (p = 0.039) discontinuation versus olanzapine oral treatment in the multivariate Cox regression. Second-generation long-acting injection antipsychotics (LAI) (p = 0.015) and first-generation long-acting injection antipsychotics (p = 0.013) showed significantly lower risks for patient-decided discontinuation than olanzapine oral. Conclusion: Higher effectiveness of clozapine and LAI treatment versus oral olanzapine were identified in a clinical cohort of patients with schizophrenia.

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“…al., kjer so raziskovalci primerjali paliperidon s kvetiapinom in placebom; podatek za aripiprazol pa iz študije avtorjev Nelsona et. al, ki najbolj ustreza vključitvenim merilom (15,23). CATIE raziskava je bila pogosto uporabljena v študijah stroškovne učinkovitosti, saj je multicentrična, vključuje 1493 preizkušancev, je naključna, dvojno slepa in ni sponzorirana (24).…”

Section: Zasnova Raziskaveunclassified

“…Verjetnost zamenjave za določeni antipsihotik smo predvideli glede na tržni delež na slovenskem trgu leta 2011 in posledično izračunali ustrezno verjetnost kot aritmetično sredino ostalih štirih antipsihotikov, ki še niso bili uporabljeni v terapiji (25). (21,22,23,15). Table 2.…”

Section: Zasnova Raziskaveunclassified

Strošek In Učinkovitost Zdravljenja Shizofrenije Z Atipičnimi Antipsihotiki V Sloveniji: Raziskava Stroškovne Učinkovitosti / The Cost And Effects Of Atypical Antipsychotic Agents In Patients With Schizophrenia In Slovenia: A Cost Effectiveness Study

Štuhec¹,

Petrica²,

Toni³

2013

Slovenian Journal of Public Health

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Risk of discontinuation of atypical antipsychotic agents in the treatment of schizophrenia

Cited by 65 publications

References 23 publications

Effectiveness of Lurasidone for Patients With Schizophrenia Following 6 Weeks of Acute Treatment With Lurasidone, Olanzapine, or Placebo

Effectiveness of Lurasidone for Patients With Schizophrenia Following 6 Weeks of Acute Treatment With Lurasidone, Olanzapine, or Placebo

Time to discontinuation of antipsychotic drugs in a schizophrenia cohort: influence of current treatment strategies

Strošek In Učinkovitost Zdravljenja Shizofrenije Z Atipičnimi Antipsihotiki V Sloveniji: Raziskava Stroškovne Učinkovitosti / The Cost And Effects Of Atypical Antipsychotic Agents In Patients With Schizophrenia In Slovenia: A Cost Effectiveness Study

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