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Abstract: Rationale: Discontinuation of antipsychotic treatment at early phases increases the risk of poor adherence to maintenance drug therapy. Differences among antipsychotics in terms of effectiveness may determine a good adherence to treatment.
Objectives: The aim of this study is to compare the clinical effectiveness of aripiprazole, ziprasidone and quetiapine in the treatment of first-episode schizophrenia spectrum disorders at 1 year.
Method: From October 2005 to January 2011 a prospective, randomized, open-label study was undertaken. Two hundred two first-episode drug-naïve patients were randomly assigned to aripiprazole (N?=?78), ziprasidone (N?=?62), or quetiapine (N?=?62) and followed up for 1 year. 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 1 year was 13.37 %. The treatment discontinuation rate differed significantly between treatment groups (aripiprazole?=?43.6 %, ziprasidone?=?66.1 % and quetiapine?=?82.3 %) (? 2?=?22.545; p?0.001). Insufficient efficacy in the group of quetiapine is the most important reason for differences in discontinuation rates between agents (? 2?=?19.436; p?0.001). The mean time to all-cause discontinuation was significantly different between groups (LogRank?=?30.732 p?0.001). The profile of extrapyramidal symptoms varies between treatments. Patients on ziprasidone were more likely to be prescribed antidepressants.
Conclusions: First episode patients treated with quetiapine have a higher risk of treatment discontinuation at midterm due to insufficient efficacy. Establishing differences between SGAs may help clinicians on prescribing decision for treatment of individuals presenting with first-episode non-affective psychosis.
Fuente: Psychopharmacology, 2014, 231, 357-366
Año de publicación: 2014
Nº de páginas: 10
Tipo de publicación: Artículo de Revista
BENEDICTO CRESPO FACORRO
ORTÍZ GARCÍA DE LA FOZ, VICTOR
IGNACIO MATA PASTOR
MARIA ROSA AYESA ARRIOLA
PAULA SUAREZ PINILLA
ELSA MARIA VALDIZAN RUIZ
OBDULIA MARTINEZ GARCIA
ROCIO PEREZ IGLESIAS