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The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: results from the CATIE study.

Publication ,  Journal Article
Swartz, MS; Wagner, HR; Swanson, JW; Stroup, TS; McEvoy, JP; Reimherr, F; Miller, DD; McGee, M; Khan, A; Canive, JM; Davis, SM; Hsiao, JK ...
Published in: Schizophr Res
March 2008

OBJECTIVE: This double-blind study compared a second generation (atypical) antipsychotic drugs compared to a representative older agent for patients with schizophrenia who use or avoid illicit substances. METHODS: Schizophrenic subjects were recruited at 57 U.S. sites and randomly assigned to olanzapine, perphenazine, quetiapine, risperidone or ziprasidone for up to 18 months. The primary aim of this analysis was to delineate differences between the overall effectiveness of these five treatments among patients who used or did not use illicit substances. RESULTS: There were no significant differences between treatment groups in time to all-cause treatment discontinuation among patients who use illicit drugs (median 3.3 to 6.8 months). Among non-users time to treatment discontinuation was significantly longer for patients treated with olanzapine (median 13.0 months) than perphenazine ( 5.9 months), risperidone (5.6 months), or quetiapine (5.0 months); time to discontinuation for ziprasidone (4.3 months) was even shorter, although the latter difference was not significant. The difference between risperidone and quetiapine, although small, was significant. All remaining differences were non-significant. Similar results were found for discontinuation due to inefficacy. There were no differences between illicit users and non-users in symptom reduction and global improvement, after adjustment for differential duration of treatment. Differences in discontinuation results were attenuated by non-compliance, but the trends persisted after controlling for treatment compliance. CONCLUSIONS: Among patients with chronic schizophrenia who avoid use of illicit drugs, olanzapine was more effective than other antipsychotics as reflected by longer time to all-cause discontinuation, but illicit substance abuse attenuated this advantage, reinforcing the need for concurrent substance abuse treatment.

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Published In

Schizophr Res

DOI

ISSN

0920-9964

Publication Date

March 2008

Volume

100

Issue

1-3

Start / End Page

39 / 52

Location

Netherlands

Related Subject Headings

  • Treatment Refusal
  • Treatment Outcome
  • Time Factors
  • Substance-Related Disorders
  • Schizophrenic Psychology
  • Schizophrenia
  • Risperidone
  • Quetiapine Fumarate
  • Psychiatry
  • Perphenazine
 

Citation

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Swartz, M. S., Wagner, H. R., Swanson, J. W., Stroup, T. S., McEvoy, J. P., Reimherr, F., … CATIE Investigators, . (2008). The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: results from the CATIE study. Schizophr Res, 100(1–3), 39–52. https://doi.org/10.1016/j.schres.2007.11.034
Swartz, Marvin S., H Ryan Wagner, Jeffrey W. Swanson, T Scott Stroup, Joseph P. McEvoy, Fred Reimherr, Del D. Miller, et al. “The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: results from the CATIE study.Schizophr Res 100, no. 1–3 (March 2008): 39–52. https://doi.org/10.1016/j.schres.2007.11.034.
Swartz MS, Wagner HR, Swanson JW, Stroup TS, McEvoy JP, Reimherr F, et al. The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: results from the CATIE study. Schizophr Res. 2008 Mar;100(1–3):39–52.
Swartz, Marvin S., et al. “The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: results from the CATIE study.Schizophr Res, vol. 100, no. 1–3, Mar. 2008, pp. 39–52. Pubmed, doi:10.1016/j.schres.2007.11.034.
Swartz MS, Wagner HR, Swanson JW, Stroup TS, McEvoy JP, Reimherr F, Miller DD, McGee M, Khan A, Canive JM, Davis SM, Hsiao JK, Lieberman JA, CATIE Investigators. The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: results from the CATIE study. Schizophr Res. 2008 Mar;100(1–3):39–52.
Journal cover image

Published In

Schizophr Res

DOI

ISSN

0920-9964

Publication Date

March 2008

Volume

100

Issue

1-3

Start / End Page

39 / 52

Location

Netherlands

Related Subject Headings

  • Treatment Refusal
  • Treatment Outcome
  • Time Factors
  • Substance-Related Disorders
  • Schizophrenic Psychology
  • Schizophrenia
  • Risperidone
  • Quetiapine Fumarate
  • Psychiatry
  • Perphenazine