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Selecting the most effective treatment represents a critical challenge with the potential of modifying the long-term prognosis of individuals suffering a first break of psychosis. Head-to-head clinical trials comparing effectiveness among antipsychotic drugs in individuals with a first-episode of non-affective psychosis (FEP) are scarce.
The rationale and design of a 3 phases clinical trial (PAFIP-3, NCT02305823) comparing the effectiveness of aripiprazole and risperidone, and to additionally assess the benefits of an early use of clozapine in primary treatment-resistant patients is reported. The design encompasses of 5 work packages (medication algorithm, cognitive functioning, psychoeducation/vocational functioning, imaging and biological markers) addressing critical issues and needs of first episode psychosis individuals and their cares. The primary outcome measure was treatment effectiveness assessed by all-cause treatment discontinuation rate.
266 individuals have been included in the randomization study phase I (risperidone vs. aripiprazole). At 3 months, the retention rate was of 94% (249/266), 48(19.3%) patients have gone through phase II (olanzapine treatment), and 7(2.8%) entered the clozapine phase (phase III).
The PAFIP 3 clinical trial may provide relevant information about clinical guidelines to optimally treat patients with a first episode of non-affective psychosis and the benefits and risks of an early use of clozapine in treatment resistant patients.
Fuente: Revista de psiquiatría y salud mental (Barcelona) 14 (2021): 157-163
Editorial: Ediciones Doyma, S.L.
Año de publicación: 2021
Nº de páginas: 7
Tipo de publicación: Artículo de Revista
Url de la publicación: https://www.doi.org/10.1016/j.rpsm.2021.01.004
MAYORAL-VAN SON, J.
MARIA ROSA AYESA ARRIOLA
JAVIER VAZQUEZ BOURGON
ORTIZ-GARCÍA DE LA FOZ, VÍCTOR
DIANA TORDESILLAS GUTIERREZ
BENEDICTO CRESPO FACORRO