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Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic.

Publication ,  Journal Article
Stroup, TS; Lieberman, JA; McEvoy, JP; Swartz, MS; Davis, SM; Rosenheck, RA; Perkins, DO; Keefe, RSE; Davis, CE; Severe, J; Hsiao, JK ...
Published in: Am J Psychiatry
April 2006

BACKGROUND: In the treatment of schizophrenia, changing antipsychotics is common when one treatment is suboptimally effective, but the relative effectiveness of drugs used in this strategy is unknown. This randomized, double-blind study compared olanzapine, quetiapine, risperidone, and ziprasidone in patients who had just discontinued a different atypical antipsychotic. METHOD: Subjects with schizophrenia (N=444) who had discontinued the atypical antipsychotic randomly assigned during phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) investigation were randomly reassigned to double-blind treatment with a different antipsychotic (olanzapine, 7.5-30 mg/day [N=66]; quetiapine, 200-800 mg/day [N=63]; risperidone, 1.5-6.0 mg/day [N=69]; or ziprasidone, 40-160 mg/day [N=135]). The primary aim was to determine if there were differences between these four treatments in effectiveness measured by time until discontinuation for any reason. RESULTS: The time to treatment discontinuation was longer for patients treated with risperidone (median: 7.0 months) and olanzapine (6.3 months) than with quetiapine (4.0 months) and ziprasidone (2.8 months). Among patients who discontinued their previous antipsychotic because of inefficacy (N=184), olanzapine was more effective than quetiapine and ziprasidone, and risperidone was more effective than quetiapine. There were no significant differences between antipsychotics among those who discontinued their previous treatment because of intolerability (N=168). CONCLUSIONS: Among this group of patients with chronic schizophrenia who had just discontinued treatment with an atypical antipsychotic, risperidone and olanzapine were more effective than quetiapine and ziprasidone as reflected by longer time until discontinuation for any reason.

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Published In

Am J Psychiatry

DOI

ISSN

0002-953X

Publication Date

April 2006

Volume

163

Issue

4

Start / End Page

611 / 622

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Thiazoles
  • Survival Analysis
  • Schizophrenic Psychology
  • Schizophrenia
  • Risperidone
  • Quetiapine Fumarate
  • Psychiatry
  • Proportional Hazards Models
 

Citation

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Stroup, T. S., Lieberman, J. A., McEvoy, J. P., Swartz, M. S., Davis, S. M., Rosenheck, R. A., … CATIE Investigators. (2006). Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry, 163(4), 611–622. https://doi.org/10.1176/ajp.2006.163.4.611
Stroup, T Scott, Jeffrey A. Lieberman, Joseph P. McEvoy, Marvin S. Swartz, Sonia M. Davis, Robert A. Rosenheck, Diana O. Perkins, et al. “Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic.Am J Psychiatry 163, no. 4 (April 2006): 611–22. https://doi.org/10.1176/ajp.2006.163.4.611.
Stroup TS, Lieberman JA, McEvoy JP, Swartz MS, Davis SM, Rosenheck RA, et al. Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry. 2006 Apr;163(4):611–22.
Stroup, T. Scott, et al. “Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic.Am J Psychiatry, vol. 163, no. 4, Apr. 2006, pp. 611–22. Pubmed, doi:10.1176/ajp.2006.163.4.611.
Stroup TS, Lieberman JA, McEvoy JP, Swartz MS, Davis SM, Rosenheck RA, Perkins DO, Keefe RSE, Davis CE, Severe J, Hsiao JK, CATIE Investigators. Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry. 2006 Apr;163(4):611–622.
Journal cover image

Published In

Am J Psychiatry

DOI

ISSN

0002-953X

Publication Date

April 2006

Volume

163

Issue

4

Start / End Page

611 / 622

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Thiazoles
  • Survival Analysis
  • Schizophrenic Psychology
  • Schizophrenia
  • Risperidone
  • Quetiapine Fumarate
  • Psychiatry
  • Proportional Hazards Models