奥氮平与精神裂症的治疗.ppt

* Key Points: As previously mentioned, time to treatment discontinuation for any cause has been identified as an important outcome parameter in the medication management of schizophrenia. This study compared five antipsychotics – clozapine (n=90), olanzapine (n=390), risperidone (n=287), quetiapine (n=133), and haloperidol (n=154) – on the time to all-cause discontinuation during the 1 year following its initiation as measured by the number of days on continuous treatment up to the first gap of 14 days. Participants included 1054 new initiators of the 5 antipsychotics in the Schizophrenia Care and Assessment Program (SCAP), a 3-year longitudinal, observational study of schizophrenia. Clozapine and olanzapine-treated patients were on their medication significantly longer than patients receiving risperidone, quetiapine, or haloperidol. Compared with olanzapine, the likelihood of discontinuation was 25%, 54%, and 158% greater among patients receiving risperidone, quetiapine, or haloperidol, respectively. However, the clozapine treatment group was 45% less likely to discontinue medication than olanzapine-treated patients. This suggests that antipsychotics appear to significantly differ in the time to all-cause discontinuation. Longer time to discontinuation was found to be highly correlated with therapeutic efficacy across the studied antipsychotics. The cause of this association will require further investigation. Reference: Zhu B, Ascher-Svanum H, Faries D, Gibson PJ, et al. Differences among antipsychotics in the time to all-cause drug discontinuation: results from a longitudinal naturalistic study of schizophrenia. Presented at IPS 2003; Boston, Massachusetts. * Key Points: In this head-to-head study of olanzapine and quetiapine, olanzapine demonstrated superiority in preventing relapse in schizophrenic patients with prominent negative symptoms as shown by the percentage of patients maintaining response with each drug at week 28. Relapse was defined a