Remission in schizophrenia: 196-week, double-blind treatment with ziprasidone vs. haloperidol

Abstract

To compare the remission rate and its time-course over 196 wk of double-blind treatment with an atypical antipsychotic, ziprasidone (80-160 mg/d given b.i.d., or 80-120 mg/d given q.d.), or a conventional antipsychotic, haloperidol (5-20 mg/d). Outcome assessments included attainment of remission (Andreasen criteria) by longitudinal analysis. Positive and Negative Syndrome Scale (PANSS) scores, Global Assessment of Functioning Scale (GAF) scores, and quality-of-life (QLS) were also assessed in the initial 40-wk study phase (n=599) and the 3-yr extension study (n=186). Discontinuation rates in the initial 40-wk core and follow-up extension studies were comparable between groups : 64 % and 65 % for the 80-160 mg/d ziprasidone group, 65 % and 58 % for the 80-120 mg/d ziprasidone group, and 60 % and 66 % for the 5-20 mg/d haloperidol group, respectively. Mean change scores from baseline to LOCF endpoint (week 40 or early termination) for PANSS negative and GAF (primary efficacy variables) were not statistically significantly different between ziprasidone and haloperidol. During the 3-yr extension study, ziprasidone-treated subjects (80-160 mg/d) were more likely to achieve remission (51 %) than haloperidol-treated (40 %) subjects (p=0.04), while there was a favourable trend associated with 80-120 mg/d ziprasidone (48 %). Compared to the haloperidol group, subjects assigned to the 80-160 mg/d ziprasidone group showed a gradual and persistent improvement in remission (p=0.006) and quality-of-life (p=0.004) in the longitudinal analyses. Significant differences in the trajectory of PANSS total and GAF scores favouring the 80-160 mg/d ziprasidone group were also observed. In this long-term, double-blind study, ziprasidone treatment was more likely to result in remission than haloperidol treatment, and was associated with greater improvement in quality-of-life.

Socio-demographic and clinical determinants of quality of life in Chinese patients with schizophrenia: a prospective study

“…Patients on atypical antipsychotics had better RP and BP QOL domains at the end of 1-year follow-up than those on conventional antipsychotics, confirming the favorable short-term effects of these drugs on QOL [13,14]. Similar to previous results [3,15], depressive symptoms negatively predicted the GH and MH QOL domains.…”

Symptomatic remission and patient quality of life in an observational study of schizophrenia: Is there a relationship?

“…Similar percentages of patients achieved symptomatic remission in the 3-year extension study of a controlled clinical trial, where symptomatic remission rates ranged from 41% in haloperidol-treated patients to 50% in ziprasidone-treated patients (Potkin et al, 2009). …”

“…For this, the regression model can be adjusted for other factors known to impact on quality of life and to be associated with remission (e.g. age, gender and medication) (Haro et al, 2006;Yen et al, 2008;Potkin et al, 2009). Finally, we have described the relationship between functional remission and quality of life.…”

Adherence, Healthcare Resource Utilization, and Costs in Medicaid Beneficiaries with Schizophrenia Transitioning from Once-Monthly to Once-Every-3-Months Paliperidone Palmitate

“…Longer injection intervals are expected to improve adherence to medication and therefore quality of life by reducing relapses and the number and duration of re-hospitalizations [16][17][18]. Following 4 months of adequate treatment with PP1M with the same dosage strength for the last two PP1M injections, patients can be transitioned to once-every-3-months paliperidone palmitate (PP3M), the only LAI with a quarterly dosing schedule.…”