Predictors of switching antipsychotic medications in the treatment of schizophrenia

Nyhuis, Allen W.; Faries, Douglas E.; Ascher-Svanum, Haya; Stauffer, Virginia L.; Kinon, Bruce J.

doi:10.1186/1471-244x-10-75

Cited by 42 publications

(44 citation statements)

References 52 publications

(53 reference statements)

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“…These findings are in line with previous reports [14, 15, 23, 24]. The mean daily doses of ZIP were approximately 140 mg in both groups according to recommended and widely used doses of ZIP [25, 26].…”

Section: Discussionsupporting

confidence: 92%

Clinical Practice Associated with a Switch from and to Ziprasidone during Routine Inpatient Treatment of Patients with Schizophrenia

Müller

2011

Schizophrenia Research and Treatment

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Ziprasidone (ZIP) shows a low propensity for metabolic side effects but can prolong QTc time. It is unclear how these features translate into clinical reality. Charts of inpatients with schizophrenia and switched from (ZIP − , n = 27) or to ZIP (ZIP + , n = 24) were reviewed. Clinical data including documented switch reasons were anonymously analyzed. Comorbidity, body mass index (BMI) at admission, illness severity, side effects, illness duration, and length of stay were comparable in both groups. About 2/3 of ZIP+ were women (1/3 of ZIP − , P = 0.035); ZIP+ patients were younger (P = 0.017), had higher BMI values (P = 0.042), and received higher chlorpromazine equivalents before switch (P = 0.004) whereas ZIP doses were comparable (136 versus 141 mg/d). More patients in ZIP− versus ZIP+ were switched because of previous weight gain (P = 0.006) and depression (P = 0.085) whereas single reasons for ZIP− versus ZIP+ were mainly persisting positive symptoms (P = 0.089) and patients' choice (P = 0.10). The results of the naturalistic study corroborate controlled trials.

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Section: Discussionsupporting

confidence: 92%

Clinical Practice Associated with a Switch from and to Ziprasidone during Routine Inpatient Treatment of Patients with Schizophrenia

Müller

2011

Schizophrenia Research and Treatment

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“…In the univariate analysis, older age13,25,27,47,48 and male gender28,44,46 predicted antipsychotic continuation. The primary findings in the multivariate analysis were also consistent with previous research on predictors of medication continuation: longer duration of illness,45 higher baseline HRQOL,58 higher baseline negative symptoms,58 and lower baseline positive symptoms59 have all been identified as predictors of antipsychotic continuation. Interestingly, in one study, lower baseline positive symptoms were reported to predict discontinuation rather than continuation 48.…”

Section: Discussionsupporting

confidence: 86%

Predictors of continuation with olanzapine during the 1-year naturalistic treatment of patients with schizophrenia in Japan

Ascher-Svanum²,

Tanji³

et al. 2011

PPA

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PurposeTreatment continuation is considered an important measure of antipsychotic effectiveness in schizophrenia, reflecting the medication’s efficacy, safety, and tolerability from both patients’ and clinicians’ perspectives. This study identified characteristics of patients with schizophrenia who continue olanzapine therapy for a 1-year period in Japan.MethodsIn a large (N = 1850), prospective, observational study, Japanese patients with schizophrenia who initiated treatment with olanzapine were followed for 1 year. Baseline characteristics were compared using t-tests and chi-square tests. Stepwise logistic regression was used to identify independent baseline predictors of treatment continuation.ResultsMost patients (68.2%) continued with olanzapine therapy for the full 1-year study period, with an average duration of 265.5 ± 119.4 days. At baseline, patients who continued were significantly more likely to be male, older, and inpatients; have longer illness duration, higher negative and cognitive symptoms, better health-related quality of life, and prior anticholinergic use. Continuers were significantly less likely to engage in social activities, live independently, work for pay, or have prior antidepressant use. Continuers showed significantly greater early (3-month) improvement in global symptom severity. Logistic regression found that continuation was significantly predicted by longer illness duration, lower positive symptoms, higher negative symptoms, and better health-related quality of life.ConclusionsIn this large naturalistic study in Japan, most patients with schizophrenia stayed on olanzapine therapy for the full 1-year study period. Treatment completion with olanzapine was independently predicted by longer illness duration, lower positive symptoms, higher negative symptoms, and better health-related quality of life.

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“…2003; Broekema et al . 2007; Barnes and Paton, 2011] or switch to other AAPs to optimize symptomatic control [Nyhius et al . 2010].…”

Section: Introductionmentioning

confidence: 99%

Use of quetiapine XR and quetiapine IR in clinical practice for hospitalized patients with schizophrenia: a retrospective study

Eriksson

Hallerbäck

Jørgensen

et al. 2012

Therapeutic Advances in Psychopharmacology

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Quetiapine fumarate, a first-line treatment for schizophrenia, exists in two formulations: extended release (XR) and immediate release (IR). This naturalistic, noninterventional study evaluated use of quetiapine XR/IR among in-patients with schizophrenia [ClinicalTrials.gov identifier: NCT01214135]. Data were collected from medical records. Categorical and numerical outcomes were compared using χ2 and t tests. Of 178 enrolled patients, 66% and 34% used quetiapine XR and IR respectively. Based on mean daily dose, XR was used as antipsychotic medication in 64% of patients compared with 40% of patients on IR (dose ≥ 400 mg/day; p = 0.002) and in higher doses than IR (494 versus 345 mg/day; p = 0.001; calculated averages). Schizophrenia was more commonly reported as reason for use of XR than IR (20% versus 0%; p = 0.0003). Patients with comorbid substance abuse or somatic disease were more likely to receive XR (p = 0.003; p = 0.03). Treatment cessation due to nonadherence was less common in patients on XR (3.4% versus 12%; p = 0.03). Polypharmacy was seen in 98% of patients. Quetiapine XR/IR usage varies in hospitalized patients with schizophrenia. XR is more often used in antipsychotic dosage; IR is more commonly used at lower doses as add-on therapy. Both quetiapine XR and IR have their place in clinical practice and provide treatment choice in schizophrenia.

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Predictors of switching antipsychotic medications in the treatment of schizophrenia

Cited by 42 publications

References 52 publications

Clinical Practice Associated with a Switch from and to Ziprasidone during Routine Inpatient Treatment of Patients with Schizophrenia

Clinical Practice Associated with a Switch from and to Ziprasidone during Routine Inpatient Treatment of Patients with Schizophrenia

Predictors of continuation with olanzapine during the 1-year naturalistic treatment of patients with schizophrenia in Japan

Use of quetiapine XR and quetiapine IR in clinical practice for hospitalized patients with schizophrenia: a retrospective study

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