Effectiveness of maintenance treatments with atypical and typical antipsychotics in stable schizophrenia with early stage: 1-year naturalistic study

Guo, Xiaofeng; Fang, Maosheng; Zhai, Jing; Wang, Bo; Wang, Chuanyue; Hu, Bin; Sun, Xiaochuan; Lv, Luxian; Zheng, Lirong; Ma, Chao; Guo, Tong; Xie, Shusen; Twamley, Elizabeth W.; Jin, Hua; Zhao, Jingping

doi:10.1007/s00213-011-2242-3

Cited by 23 publications

(25 citation statements)

References 33 publications

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“…Two years after starting treatment the proportion still taking clozapine was 81.8% which is higher than in the study by Essock et al where it was 66%. In a naturalistic Chinese study which compared the discontinuation rate of clozapine to other antipsychotics 1 year after starting treatment in early stage schizophrenia, 62.3% of patients remained on clozapine (19). We can only speculate why the proportion is even higher in Iceland.…”

Section: Discussionmentioning

confidence: 87%

Clozapine treatment and discontinuation in Iceland: A national longitudinal study using electronic patient records

Ingimarsson

MacCabe

Jónsdóttir

et al. 2016

Nordic Journal of Psychiatry

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Background: Clozapine is the only drug approved for treatment-resistant schizophrenia. There is evidence that clozapine is underutilized. Aims: To evaluate the initiation and discontinuation of clozapine at Landspitali University Hospital in Iceland and the prevalence of antipsychotic polypharmacy in clozapine-treated patients. Methods: The study is a part of an ongoing longitudinal study of schizophrenia in Iceland. We identified 201 patients on clozapine or who have been on clozapine by using a keyword search in the electronic health records and by reviewing their medical records. Results: Mean age at first treatment with clozapine was 37.8 years. Mean follow-up period on clozapine was 11 years. After 20 years of treatment 71.2% of patients were still on clozapine. After one year of treatment 84.4% of patients were still receiving clozapine treatment. We estimate that 11.4% of patients with schizophrenia in Iceland are taking clozapine and that 16% have been treated with clozapine at some point. Polypharmacy is common, since nearly 2/3, 65.6%, of patients taking clozapine use at least one other antipsychotic and 16.9% are also receiving depot injections. Conclusions: We need to increase the awareness of psychiatrists in Iceland with regard to treatment with clozapine, since only about half of the estimated population of patients with treatment-resistant schizophrenia in Iceland have ever been treated with clozapine. Nearly two thirds of patients who are prescribed clozapine in Iceland remain on it long-term.

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Section: Discussionmentioning

confidence: 87%

Clozapine treatment and discontinuation in Iceland: A national longitudinal study using electronic patient records

Ingimarsson

MacCabe

Jónsdóttir

et al. 2016

Nordic Journal of Psychiatry

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“…Studies assessing effectiveness were made up of RCTs (n=3),19–21 nonrandomized open-label studies (n=2),22,23 observational studies (n=2),24,25 a cross-sectional comparative study,26 and a cohort study 27. The mean duration of these studies was 37 weeks (median 52, range 12–52) and the mean number of enrolled patients was 690.3 (median 698, range 60–1,227).…”

Section: Resultsmentioning

confidence: 99%

“…Data on treatment discontinuation were provided for Chinese patients receiving olanzapine or other antipsychotic agents in a cohort study and in an observational study, in which both populations received maintenance therapy for 12 months 22,24. For olanzapine, 12-month total discontinuation rates of 39.6% and 44.0% were reported in these studies 22,24.…”

Section: Resultsmentioning

confidence: 99%

Olanzapine in Chinese patients with schizophrenia or bipolar disorder: a systematic literature review

Xue

Liu

Zhang

et al. 2014

NDT

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BackgroundDespite the burden of schizophrenia and bipolar disorder in the Chinese population, country-specific data to guide practitioners regarding antipsychotic therapy are lacking. The primary aim of this systematic review was to examine evidence of the efficacy, effectiveness, and safety of olanzapine in Chinese populations.MethodsA systematic literature search was conducted using databases covering international and Chinese core journals using search terms related to schizophrenia and bipolar disorder, specified countries (People’s Republic of China, Hong Kong, Taiwan), and olanzapine treatment. Following initial screening, inclusion and exclusion criteria were applied to the search results to identify relevant studies from which data were extracted.ResultsA total of 489 publications were retrieved and 61 studies were identified for inclusion. Most studies were related to schizophrenia (n=54), with six studies related to bipolar disorder and one study related to both conditions. The quality of study methods and reporting in international journals was noticeably better than in Chinese language journals. Most studies included relatively small patient populations and were of short duration. The efficacy of olanzapine in Chinese populations was confirmed by multiple comparative and noncomparative studies that found statistically significant reductions in symptom measures in studies conducted for ≥6 weeks (schizophrenia) or ≥3 weeks (bipolar disorder). Findings related to effectiveness (treatment discontinuation, quality of life, and neurocognitive improvements) were generally consistent with those observed in non-Chinese populations. No new safety signals specific for Chinese populations were raised for olanzapine.ConclusionChinese and non-Chinese populations with schizophrenia or bipolar disorder treated with olanzapine display broadly similar responses. Differences between these populations, especially in relation to the relative efficacy of olanzapine versus other antipsychotics, may warrant further investigation via studies incorporating both populations. Use of local data to provide evidence for practice guidelines should be encouraged, and may promote ongoing improvements in the quality of research and study reporting.

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“…Five studies were observational 12,13,15,17,20 , and eight were open label [25][26][27][28][29][30]32,33 ; two of the observational studies 12,13 and five of the open-label studies 25,27,28,30,32 assessed the effect on weight gain when switching patients to aripiprazole (Table 2).…”

Section: Body Weight and Bmimentioning

confidence: 99%

“…16) and lower for risperidone (OR ¼ 0.82) when compared with aripiprazole, the results were not statistically significant 15 . In a 12 month, prospective, observational, multicenter study in patients within 5 years of onset of schizophrenia (n ¼ 1133) receiving monotherapy with aripiprazole, chlorpromazine, clozapine, olanzapine, quetiapine, risperidone, or sulpiride, it was found that patients in the olanzapine group gained significantly more weight compared with those receiving the other treatments (p 0.005) 17 .…”

Section: Body Weight and Bmimentioning

confidence: 99%

A review of real-world data on the effects of aripiprazole on weight and metabolic outcomes in adults

Citrome

Kalsekar

Baker

et al. 2014

Current Medical Research and Opinion

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Effectiveness of maintenance treatments with atypical and typical antipsychotics in stable schizophrenia with early stage: 1-year naturalistic study

Cited by 23 publications

References 33 publications

Clozapine treatment and discontinuation in Iceland: A national longitudinal study using electronic patient records

Clozapine treatment and discontinuation in Iceland: A national longitudinal study using electronic patient records

Olanzapine in Chinese patients with schizophrenia or bipolar disorder: a systematic literature review

A review of real-world data on the effects of aripiprazole on weight and metabolic outcomes in adults

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