Antipsychotic Treatment Effectiveness in First Episode of Psychosis: PAFIP 3-Year Follow-Up Randomized Clinical Trials Comparing Haloperidol, Olanzapine, Risperidone, Aripiprazole, Quetiapine, and Ziprasidone
| Autor: | Esther Setién Suero, Rosa Ayesa-Arriola, Benedicto Crespo-Facorro, Marcos Gómez-Revuelta, Javier Vázquez-Bourgon, María Juncal-Ruiz, Paula Suárez-Pinilla, Rodrigo Romero-Jiménez, José María Pelayo-Terán |
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| Přispěvatelé: | Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Fundació Seny, Fundación Marques de Valdecilla, Junta de Castilla y León |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Olanzapine medicine.medical_specialty AcademicSubjects/MED00415 Adolescent Aripiprazole Regular Research Articles Piperazines law.invention Quetiapine Fumarate Young Adult Randomized controlled trial law Internal medicine Outcome Assessment Health Care Humans Antipsychotics Medicine Pharmacology (medical) Ziprasidone First-episode-psychosis Pharmacology First episode Risperidone AcademicSubjects/SCI01870 business.industry Discontinuation Thiazoles Psychiatry and Mental health Psychotic Disorders Schizophrenia Haloperidol Quetiapine Female business Antipsychotic Agents Follow-Up Studies medicine.drug |
| Zdroj: | International Journal of Neuropsychopharmacology (2020) 23(4): 217-229 UCrea Repositorio Abierto de la Universidad de Cantabria instname Digital.CSIC. Repositorio Institucional del CSIC International Journal of Neuropsychopharmacology |
| ISSN: | 1469-5111 1461-1457 |
| DOI: | 10.1093/ijnp/pyaa004 |
| Popis: | [Background] Different effectiveness profiles among antipsychotics may be a key point to optimize treatment in patients suffering a first episode of psychosis to impact on long-term outcome. The aim of this study is to compare the clinical effectiveness of olanzapine, risperidone, haloperidol, aripiprazole, ziprasidone, and quetiapine in the treatment of first episode of psychosis at 3-year follow-up. [Method] From February 2001 to January 2011, 2 phases of a prospective, randomized, open-label study were undertaken. A total of 376 first-episode drug-naïve patients were randomly assigned to olanzapine (n = 55), risperidone (n = 63), haloperidol (n = 56), aripiprazole (n = 78), ziprasidone (n = 62), or quetiapine (n = 62) and followed up for 3 years. The primary effectiveness measure was all cause of treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted in the analysis for clinical efficacy. [Results] The overall dropout rate at 3 years reached 20.75%. Treatment discontinuation rates were significantly different among treatment groups (olanzapine = 69.09, risperidone = 71.43, aripiprazole = 73.08%, ziprasidone = 79.03%, haloperidol = 89.28%, and quetiapine = 95.53%) (χ2 = 79.86; P = .000). Statistically significant differences in terms of lack of efficacy, adherence, and tolerability were observed among treatment groups along the 3-year follow-up, determining significant differences in time to all-cause discontinuation (log-rank = 92.240; P = .000). Significant differences between treatments were found in the categories of sleepiness/sedation, increased sleep duration, akinesia, weight gain, ejaculatory dysfunction, extrapyramidal-symptoms, and amenorrhea. [Conclusions] Olanzapine, risperidone, and aripiprazole presented advantages for the first-line treatment of first episode of psychosis in terms of effectiveness. Identifying different discontinuation patterns may contribute to optimize treatment selection after first episode of psychosis. The study was carried out at the Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain, under the following grant supports: Plan Nacional de Drogas Research (2005-Orden sco/3246/2004); SENY Fundació (CI 2005–0308007); and Fundación Marqués de Valdecilla (API07/011); Gerencia Regional de Salud de Castilla y León (INT/M/04/17). |
| Databáze: | OpenAIRE |
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