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Antipsychoticswitching versusaugmentation amongearly non-respondersto risperidone orolanzapine inacute-phaseschizophrenia Kotaro HattaTaro OtachiKiyoshi Fujita2014 год

Antipsychotic switching versus augmentation among early non-responders to risperidone or olanzapine in acute-phase schizophrenia
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Аннотация: We examined whether augmentation with olanzapine would be superior to switching to olanzapine among early non-responders (ENRs) to risperidone, and whether augmentation with risperidone would be superior to switching to risperidone among ENRs to olanzapine. We performed a rater-blinded, randomized clinical trial at psychiatric emergency sites. Eligible patients were newly admitted patients with acute schizophrenia. ENRs to the initial antipsychotic (Clinical Global Impressions-Improvement Scale: ≥ 4 at 2 weeks) were allocated to receive either augmentation with or switching to the other antipsychotic (RIS + OLZ vs. RIS-OLZ; OLZ + RIS vs. OLZ-RIS). Sixty patients who completed 2 weeks of risperidone treatment were divided into 33 early responders (RIS-ER) and 27 ENRs (RIS + OLZ, n = 14; RIS-OLZ, n = 13). Although time to treatment discontinuation for any cause was significantly shorter in RIS + OLZ group (54.1 days [95% confidence interval, 41.3-67.0]) than in RIS-ER group (68.7 [61.2-76.2]; P = 0.050), it was not significantly shorter in RIS-OLZ group (58.5 [43.1-73.9]) than in RIS-ER group (P = 0.19). Sixty patients who completed 2 weeks of olanzapine treatment were divided into 36 early responders (OLZ-ER) and 24 ENRs (OLZ + RIS, n = 11; OLZ-RIS, n = 13). Although time to treatment discontinuation for any cause was significantly shorter in OLZ-RIS group (56.1 days [40.7-71.5]) than in OLZ-ER group (74.9 [68.5-81.3]; P = 0.008), it was not significantly shorter in OLZ + RIS group (64.6 [49.6-79.6]) than in OLZ-ER group (P = 0.20). Despite the lack of pharmacokinetic investigation of dose adequacy in this study, it is possible that switching to olanzapine among ENRs to risperidone might have a small advantage over augmentation with olanzapine, while augmentation with risperidone might have a small advantage over switching to risperidone among ENRs to olanzapine. Further research is required before it would be appropriate to modify routine practice in the direction of these findings.
Год издания: 2014
Авторы: Kotaro Hatta, Taro Otachi, Kiyoshi Fujita, Fumiyoshi Morikawa, Shin Ito, Hirofumi Tomiyama, Takayuki Abe, Yasuhiko Sudo, Hiroshi Takebayashi, Toru Yamashita, Shigemasa Katayama, Reiko Nakase, Yutaka Shirai, Chie Usui, Hiroyuki Nakamura, Hiroto Ito, Toyoaki Hirata, Yutaka Sawa
Издательство: Elsevier BV
Источник: Schizophrenia Research
Ключевые слова: Schizophrenia research and treatment, Mental Health and Psychiatry, Treatment of Major Depression
Другие ссылки: Schizophrenia Research (HTML)
PubMed (HTML)