Efficacy of risperidone versus olanzapine in patients with schizophrenia previously on chronic conventional antipsychotic therapy: A switch study

Wang, Xiaohong; Savage, Robert M.; Borisov, Andrey S.; Rosenberg, Jill; Woolwine, Bobbi J.; Tucker, Melanie T.; May, Roberta S.; Feldman, Jacqueline; Nemeroff, Charles B.; Miller, Andrew H.

doi:10.1016/j.jpsychires.2006.03.008

Cited by 28 publications

(21 citation statements)

References 19 publications

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“…Collectively, these findings are consistent with previous studies showing a benefit of switching antipsychotic medications on symptom severity in patients with schizophrenia or schizoaffective disorder (Canive et al, 2006;Simpson et al, 2008;Takahashi et al, 2006a,b;Wang et al, 2006). Our data did not support the post hoc finding of 'no benefit' in switching antipsychotic medications in patients who were randomized to stay on their medication ('stayers') vs those who were randomized to 'switched to another drug' ('switchers') reported from the CATIE trial (Essock et al, 2006;Rosenheck et al, 2009).…”

Section: Discussionsupporting

confidence: 91%

“…The clinical dilemma in these patients who do not show early response is whether one should 'switch' or 'stay'. Although favorable outcomes were previously reported for patients with a poor or limited response to one antipsychotic drug following a switch to another (Canive et al, 2006;Simpson et al, 2008;Wang et al, 2006;Takahashi et al, 2006a;Takahashi et al, 2006b), such studies typically lack a control group (of patients staying on the original drug for an equal interval) and, therefore, we cannot conclude that switching is indeed a beneficial option. Importantly, no benefit of switching antipsychotic medications was reported in two post hoc analyses of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) trial that included a control group (Essock et al, 2006;Rosenheck et al, 2009).…”

Section: Introductionmentioning

confidence: 74%

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Early Response to Antipsychotic Drug Therapy as a Clinical Marker of Subsequent Response in the Treatment of Schizophrenia

Kinon

Chen

Ascher-Svanum

et al. 2009

Neuropsychopharmacol

165

168

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Our objective was to prospectively assess whether early (ie, 2 weeks) response to an antipsychotic predicts later (12-week) response and whether 'switching' early non-responders to another antipsychotic is a better strategy than 'staying'. This randomized, double-blind, flexible-dosed, 12-week study enrolled 628 patients diagnosed with schizophrenia or schizoaffective disorder. All initiated treatment with risperidone. Early response was defined as X20% improvement on the Positive and Negative Syndrome Scale (PANSS) total score following 2 weeks of treatment. Early responders (ERs) continued on risperidone, whereas early non-responders (ENRs) were randomized (1 : 1) to continue on risperidone 2-6 mg/day or switch to olanzapine 10-20 mg/day for 10 additional weeks. Compared with ENRs, risperidone ERs showed significantly greater reduction in PANSS total score (end point; po001). Early response/nonresponse was highly predictive of subsequent clinical outcomes. Switching risperidone ENRs to olanzapine at week 2 resulted in a small but significantly greater reduction in PANSS total score (end point; p ¼ 0.020) and in depressive symptoms (end point; p ¼ 0.004); the reduction in PANSS was greater among those who were still moderately ill at 2 weeks. Switching risperidone ENRs to olanzapine also resulted in significantly greater increases in triglycerides, a significantly greater decrease in prolactin, and significantly less treatmentemergent dyskinesia. This is the first study to prospectively show that early response/non-response to an antipsychotic (risperidone) is a reliable clinical marker of subsequent clinical outcomes and that a 'switching' strategy based on this information may lead to greater clinical improvement than staying on a drug for a longer period in some patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 74%

Early Response to Antipsychotic Drug Therapy as a Clinical Marker of Subsequent Response in the Treatment of Schizophrenia

Kinon

Chen

Ascher-Svanum

et al. 2009

Neuropsychopharmacol

165

168

View full text Add to dashboard Cite

show abstract

“…44,47,50,108,[114][115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130][131] ( Table 3) Twenty-five articles were identified that reported relevant data. One of these 101 was also reported in Table 1 because overt violence was an outcome measure.…”

Section: Resultsmentioning

confidence: 99%

Pharmacological Management of Persistent Hostility and Aggression in Persons With Schizophrenia Spectrum Disorders: A Systematic Review

Victoroff

Coburn

Reeve

et al. 2014

JNP

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The incidence of aggressive behaviors is higher among persons with schizophrenia spectrum disorders (SSDs) than among persons without such disorders. This phenomenon represents a risk to the well-being of patients, their families, and society. The authors undertook a systematic review of the English language literature to determine the efficacy of neuropharmacological agents for the management of hostility and aggression among persons with SSDs. The search combined findings from the Medline, EMBASE, and PsycINFO databases. Ninety-two full text articles were identified that reported relevant findings. The American Academy of Neurology criteria were used to determine levels of evidence. Paliperidone-extended release is probably effective for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level B). Clozapine is possibly more effective than haloperidol for the management of overt aggression and possibly more effective than chlorpromazine for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level C). Clozapine is also possibly more effective than olanzapine or haloperidol for reducing aggression among selected physically assaultive inpatients (Level C). Adjunctive propranolol, valproic acid, and famotidine are possibly effective for reducing some aspects of hostility or aggression among inpatients with SSDs (Level C). Paliperidone-extended release currently appears to be the agent for the management of hostility among inpatients with SSDs for which there is the strongest evidence of efficacy.

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“…Switching studies, primarily from typical to atypical, have shown a reduction in anxiety and psychotic symptoms (olanzapine [Noordsy, O'Keefe, Mueser, & Xie, ]; risperidone or olanzapine after 2–6 years [Voruganti et al, ]; risperidone or olanzapine after 8 weeks in older adult [Jeste, Barak, Madhusoodanan, Grossman, & Gharabawi, ]), whereas others have reported an increase in anxiety (7.4%) with increased psychotic symptoms (11.7%; haloperidol to olanzapine after 6 weeks [Costa e Silva et al, ]). Some studies have found increased efficacy for some atypical antipsychotics (risperidone vs. olanzapine after 22 weeks, with comparable attenuation of psychotic symptoms [X. Wang et al, ]; olanzapine to risperidone due to incompatibility, accompanied by attenuation of psychotic symptoms [Ganguli, Brar, Mahmoud, Berry, & Pandina, ]). Care should be taken when switching antipsychotic medications, as this may lead to development of anxiety (Borison, ; Delassus‐Guenault et al, ; Poyurovsky, Bergman, Shoshani, Schneidman, & Weizman, ).…”

Section: Pharmacological Treatment Of Anxiety In Schizophreniamentioning

confidence: 99%

Current and potential pharmacological and psychosocial interventions for anxiety symptoms and disorders in patients with schizophrenia: structured review

Howells

Kingdon

Baldwin

2017

Human Psychopharmacology

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Efficacy of risperidone versus olanzapine in patients with schizophrenia previously on chronic conventional antipsychotic therapy: A switch study

Cited by 28 publications

References 19 publications

Early Response to Antipsychotic Drug Therapy as a Clinical Marker of Subsequent Response in the Treatment of Schizophrenia

Early Response to Antipsychotic Drug Therapy as a Clinical Marker of Subsequent Response in the Treatment of Schizophrenia

Pharmacological Management of Persistent Hostility and Aggression in Persons With Schizophrenia Spectrum Disorders: A Systematic Review

Current and potential pharmacological and psychosocial interventions for anxiety symptoms and disorders in patients with schizophrenia: structured review

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