Comparative effectiveness and safety of antipsychotic drugs in schizophrenia treatment: a real‐world observational study

Abstract

Both findings call for an international public health and drug agencies surveillance of 'real-world' antipsychotic medication to ensure the optimal choices in treatment guidelines for SZ.

A clozapine paradox?

“…In their large observational study, Vanasse et al showed that clozapine was more effective than other antipsychotics with regard to real-world clinical outcomes (i.e., suicide, hospitalization, and emergency department visit for mental disorders). 1 Their finding is in line with existing experimental and observational evidence that supports the current status of clozapine as the gold standard treatment for refractory schizophrenia.…”

Real‐world effectiveness of antipsychotics

“…In this issue of the Journal, Vanasse et al. report results on the comparative effectiveness of antipsychotic drugs in schizophrenia. The authors used administrative databases from Quebec province in Canada, which included more than 18 000 patients who started to use an antipsychotic from 1998 to 2005.…”

Antipsychotics and mortality in a nationwide cohort of 29,823 patients with schizophrenia

“…Our results are in line with all previous large observational cohort studies (Tiihonen et al, Table 1 The mortality rates during monotherapy of specific antipsychotics among the prevalent and incident cohorts. 2006, 2011, 2012Baandrup et al, 2010, Crump et al, 2013: Vanasse et al, 2016 and meta-analyses on RCTs (Baxter et al, 2016;Khan et al, 2007Khan et al, , 2013. The lowest risk of death was observed during those time periods when patients used second generation LAIs, both in the prevalent and incident cohorts.…”

“…Several observational studies on large unselected cohorts have shown that mortality is lower during use of antipsychotic compared with no use (Tiihonen et al, 2006(Tiihonen et al, , 2009(Tiihonen et al, , 2011(Tiihonen et al, , 2012Baandrup et al, 2010;Crump et al, 2013;Vanasse et al, 2016). However, these studies either did not control for survival bias or had short follow-up periods which made it difficult to evaluate the comparative effectiveness between specific antipsychotics.…”