Extrapyramidal symptoms during treatment of first schizophrenia episode: Results from EUFEST

Rybakowski, Janusz; Vansteelandt, Kristof; Remlinger-Molenda, Agnieszka; Fleischhacker, W. Wolfgang; Kahn, René S.

doi:10.1016/j.euroneuro.2014.07.001

Cited by 28 publications

(28 citation statements)

References 22 publications

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“…The occurrence of EPS has been previously demonstrated to relate to both negative and depressive symptoms. 24 However, consistent with our results, 1 study reported that depression in patients with stable schizophrenia was not correlated with EPS. 25 The underlying reason for these differential findings is unclear as few studies have explored the relationship between EPS and the 5 factors of the PANSS.…”

Section: Study Summarysupporting

confidence: 89%

Extrapyramidal Symptoms During Risperidone Maintenance Treatment in Schizophrenia

Wang

et al. 2016

Journal of Clinical Psychopharmacology

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The risperidone maintenance treatment in schizophrenia study was designed to identify the duration of maintenance treatment required with an initial therapeutic dose in contrast to reducing the dose over time. This study investigated extrapyramidal symptoms (EPSs) in different risperidone maintenance treatment paradigms over 1 year. Clinically stabilized patients with schizophrenia (n = 374) were randomized to a no-dose-reduction group and 4-week and 26-week reduction groups, in which the dose was gradually reduced by 50% over 8 weeks and maintained. Extrapyramidal symptoms were assessed at baseline and monthly for 6 months, followed by every 2 months. The Simpson-Angus Scale of Extrapyramidal Symptoms-Chinese version assessed EPS severity. Data were analyzed by a generalized linear mixed model (GLMM). The frequency of EPS at baseline was 23.2%, 20.0%, and 21.3% in the 4-week, 26-week, and no-dose-reduction groups, respectively. Risperidone dosage, positive symptoms, and disorganized thoughts at baseline predicted development of EPS. The GLMM indicated that a significant decrease in EPS was maintained, and different trajectories occurred over time across groups. In the 235 patients who continued treatment after 1 year, the incidence of EPS decreased to 4.1%, 2.8%, and 10.0% in the 4-week, 26-week, and no-dose-reduction groups, respectively, whereas the numbers of dropouts because of intolerable EPS were not significantly different (4.8%, 6.7%, and 6.2%, respectively). These novel findings indicate EPSs were tolerable and differentially decreased depending on the dose paradigm during the 1-year treatment period. Future studies should implement a GLMM to investigate antipsychotic adverse effects during long-term treatment.

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Section: Study Summarysupporting

confidence: 89%

Extrapyramidal Symptoms During Risperidone Maintenance Treatment in Schizophrenia

Wang

et al. 2016

Journal of Clinical Psychopharmacology

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“…Analogous to the CATIE, a dichotomous variable (absent v. present) was created for each extrapyramidal side effect. The same procedure was employed by other researchers studying extrapyramidal side effects in the EUFEST (Rybakowski et al, 2014). Alcohol and substance abuse/dependence were examined using the Mini-International Neuropsychiatric Interview (MINI); the MINI-Plus version was used (Sheehan et al, 1998).…”

Section: Methodsmentioning

confidence: 99%

Treatment adherence in schizophrenia: A patient-level meta-analysis of combined CATIE and EUFEST studies

Czobor

Dorn

Citrome

et al. 2015

European Neuropsychopharmacology

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The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) obtained a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) studied a sample of 498 patients. We have combined these two samples to study the predictors and correlates of adherence to treatment. Here we report on adherence to pharmacological treatment at the six and twelve month assessments of these trials with a combined subsample of 1154 schizophrenia patients. Individual patients’ data were used for analyses. We used logistic regression to examine the effects of substance use, akathisia, parkinsonism, dyskinesia, hostility, and insight on pharmacological adherence. The results showed that reduced adherence to pharmacological treatment was associated with substance use (p=0.0003), higher levels of hostility (p=0.0002), and impaired insight (p<0.0001). Furthermore, poor adherence to study medication was associated with earlier discontinuation in the combined data. The clinical implications of the results point to the importance of routine assessments and interventions to address patients’ insight and comorbid substance use and the establishment of therapeutic alliance.

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“…In comparison, the incidence and prevalence rates of DRMDs during the first years of antipsychotic treatment are relatively understudied, 5 especially for SGA treatment. The European First-Episode Schizophrenia Trial (EUFEST) recently studied a large population over their first years of treatment 8,9 (age, 26 ± 6 years; illness duration, <2 years). They reported remarkably high DRMD prevalence rates, as high as 34% for FGAs and 28% for SGAs.…”

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confidence: 99%

High Incidence and Prevalence of Drug-Related Movement Disorders in Young Patients With Psychotic Disorders

Mentzel¹,

Lieverse²,

Bloemen³

et al. 2017

J Clin Psychopharmacol

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Extrapyramidal symptoms during treatment of first schizophrenia episode: Results from EUFEST

Cited by 28 publications

References 22 publications

Extrapyramidal Symptoms During Risperidone Maintenance Treatment in Schizophrenia

Extrapyramidal Symptoms During Risperidone Maintenance Treatment in Schizophrenia

Treatment adherence in schizophrenia: A patient-level meta-analysis of combined CATIE and EUFEST studies

High Incidence and Prevalence of Drug-Related Movement Disorders in Young Patients With Psychotic Disorders

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