TITLE

Effectiveness of second-generation antipsychotics: a naturalistic, randomized comparison of olanzapine, quetiapine, risperidone, and ziprasidone

AUTHOR(S)
Johnsen, Erik; A.^Kroken, Rune; Wentzel-Larsen, Tore; A.^Jørgensen, Hugo
PUB. DATE
January 2010
SOURCE
BMC Psychiatry;2010, Vol. 10, p26
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: No clear recommendations exist regarding which antipsychotic drug should be prescribed first for a patient suffering from psychosis. The primary aims of this naturalistic study were to assess the head-to-head effectiveness of first-line second-generation antipsychotics with regards to time until drug discontinuation, duration of index admission, time until readmission, change of psychopathology scores and tolerability outcomes. Methods: Patients = 18 years of age admitted to the emergency ward for symptoms of psychosis were consecutively randomized to risperidone (n = 53), olanzapine (n = 52), quetiapine (n = 50), or ziprasidone (n = 58), and followed for up to 2 years. Results: A total of 213 patients were included, of which 68% were males. The sample represented a diverse population suffering from psychosis. At admittance the mean Positive and Negative Syndrome Scale (PANSS) total score was 74 points and 44% were antipsychotic drug naïve. The primary intention-to-treat analyses revealed no substantial differences between the drugs regarding the times until discontinuation of initial drug, until discharge from index admission, or until readmission. Quetiapine was superior to risperidone and olanzapine in reducing the PANSS total score and the positive subscore. Quetiapine was superior to the other drugs in decreasing the PANSS general psychopathology subscore; in decreasing the Clinical Global Impression - Severity of Illness scale score (CGI-S); and in increasing the Global Assessment of Functioning - Split version, Functions scale score (GAF-F). Ziprasidone was superior to risperidone in decreasing the PANSS positive symptoms subscore and the CGI-S score, and in increasing the GAF-F score. The drugs performed equally with regards to most tolerability outcomes except a higher increase of hip-circumference per day for olanzapine compared to risperidone, and more galactorrhoea for risperidone compared to the other groups. Conclusions: Quetiapine appears to be a good starting drug candidate in this sample of patients admitted to hospital for symptoms of psychosis. Trial Registration: ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/: NCT00932529.
ACCESSION #
49160257

 

Related Articles

  • Review: "Warning: Psychiatry Can Be Hazardous To Your Mental Health". Lennon, Brian // International Journal of Reality Therapy;Fall2003, Vol. 23 Issue 1, p15 

    This article reviews Dr. Glasser's latest book "Warning: Psychiatry can be hazardous to your mental health". It outlines his objections to psychiatric medication and the premises on which they are based. Glasser's new emphasis on the promotion of mental health is explained as is his concept of...

  • Abstracts d'articles par Eduardo Mahiu.  // Mentalites;2005, Vol. 19 Issue 2, p85 

    This section presents abstracts of articles, including "Mechanism of New Antipsychotic Medications. Occupancy Is Not Just Antagonism," by Gerhard Gründer, Arvid Carlsson, and Dean F. Wong in "Arch Gen Psychiatry, issue 60, 2003; "Aproximación psicopatológica a El Quijote (según la...

  • Forced Drugging. Marshall, Eliot // New Republic;8/26/78-9/2/78, Vol. 179 Issue 9/10, p13 

    Examines the hard side of psychiatry or the side that forcefully interferes with the brain or constrains human behavior. Importance of the psychotropic drug as the psychiatrist's most important tool for controlling behavior; Most controversial drugs in the category such as major tranquilizers or...

  • Prescription Privileges for Psychologists: A Comprehensive Review and Critical Analysis of Current Issues and Controversies. Lavoie, Kim L.; Barone, Silvana // CNS Drugs;2006, Vol. 20 Issue 1, p51 

    The debate over whether clinical psychologists should be granted the right to prescribe psychoactive medications has received considerable attention over the past 2 decades in North America and, more recently, in the UK. Proponents of granting prescription privileges to clinical psychologists...

  • Try psychology before drugs for children with mental problems. Tanne, Janice Hopkins // BMJ: British Medical Journal (International Edition);9/23/2006, Vol. 333 Issue 7569, p619 

    The author reports that a study by the American Psychological Association has determined that drugs are used to treat children and adolescents with behavioral and mental difficulties even though there is little scientific evidence for their safety and efficacy. Psychological treatments are not...

  • THE DIFFERENT STUDY FOCI IN MENTAL HEALTH. Villar Luis, Margarita Antonia // SMAD Revista Electronica Salud Mental, Alcohol y Drogas;Jan-Apr2013, Vol. 9 Issue 1, p1 

    The article discusses various reports published within the issue which includes use of alcohol and other psychoactive drugs by high school students, overall impact of psychoactive substances on health and manifestation of mental distress and expressions of divergent behaviors.

  • Highlights of this issue. Shergill, Sukhwinder S. // British Journal of Psychiatry;Jan2005, Vol. 186, pA1 

    The article discusses various reports published within the issue, including one discussing the relationship between environment and mental health and another reviewing the mechanism of action of antipsychotic drugs.

  • Characteristics of fire-setters. A study and proposed multiaxial psychiatric classification. Puri, B. K.; Baxter, R.; Cordess, C. C. // British Journal of Psychiatry;Mar95, Vol. 166, p393 

    Background: The study set out to review the relationship between mental disorder and fire-setting.Method: Sociodemographic, psychiatric, and medical data were retrospectively obtained from case notes of a group of 36 fire-setters referred to the North West Thames...

  • "Continuous" Thioproperazine: A Controlled Trial in Chronic Schizophrenia. MacLeod, E. C.; Moffat, J. // British Journal of Psychiatry;Jul63, Vol. 109 Issue 461, p531 

    The article investigates the use of thioproperazine, a phenothiazine derivative which readily produces extra-pyramidal disturbances, for chronic schizophrenics. Several investigators have reported impressive results with this drug in a variety of mentally ill patients, including chronic...

Share

Read the Article

Courtesy of NEW JERSEY STATE LIBRARY

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics