Disorders - Psychosis Disorders
Bola, John, Kao, Dennis, Soydan, Haluk
Background: Objectives: Search
Strategy: Selection Criteria: Data Collection and Analysis: Main Results: Authors' Conclusions: Long-term treatment with antipsychotic medications
in early episode schizophrenia spectrum disorders is common, but both short and long-term effects on the illness are unclear. There have been
numerous suggestions that people with early episodes of schizophrenia appear to respond differently than those with multiple prior episodes. The
number of episodes may moderate response to drug treatment.To assess the effects of antipsychotic medication treatment on people with early episode
schizophrenia spectrum disorders.We searched the Cochrane Schizophrenia Group register (July 2007) as well as references of included studies. We
contacted authors of studies for further data.Studies with a majority of first and second episode schizophrenia spectrum disorders comparing initial
antipsychotic medication treatment with placebo, milieu, or psychosocial treatment.Working independently, we critically appraised records from
681studies, of which five studies met inclusion criteria. John Rathbone from the Schizophrenia Group supported us with the data extraction. We
calculated risk ratios (RR) and their 95% confidence intervals (CI) where possible. For continuous data, we calculated mean difference (MD). We
calculated numbers needed to treat/harm (NNT/NNH) where appropriate.Five studies with a combined N = 998 met inclusion criteria. Four studies (N =
724) provided leaving the study early data and results suggested that individuals treated with a typical antipsychotic medication are less likely to
leave the study early than those treated with placebo (Chlorpromazine: 3 RCTs N = 353, RR 0.4 CI 0.3 to 0.5, NNT 3.2, Fluphenaxine: 1 RCT N = 240, RR
0.5 CI 0.3 to 0.8, NNT 5; Thioridazine: 1 RCT N = 236, RR 0.44 CI 0.3 to 0.7, NNT 4.3, Trifulperazine: 1 RCT N = 94, RR 0.96 CI 0.3 to 3.6). Two
studies (Cole 1964; May 1976) contributed data to assessment of side effects and present a general pattern of more frequent side effects among
individuals treated with typical antipsychotic medications compared to placebo. Rappaport 1978 suggested a higher rehospitalisation rate for those
receiving chlorpromazine compared to placebo (N = 80, RR 2.29 CI 1.3 to 4.0, NNH 2.9). However, a higher attrition in the placebo group is likely to
have introduced a survivor bias into this comparison, as this difference becomes non-significant in a sensitivity analysis on intent-to-treat
participants (N = 127, RR 1.69 CI 0.9 to 3.0). One study (May 1976) contributes data to a comparison of trifluoperazine to psychotherapy on long-term
health in favour of the trifluoperazine group (N = 92, MD 5.8 CI 1.6 to 0.0); however, data from this study are also likely to contain biases due to
selection and attrition. One study (Mosher 1995) contributes data to a comparison of typical antipsychotic medication to psychosocial treatment on
six-week outcome measures of global psychopathology (N = 89, MD 0.01 CI -0.6 to 0.6) and global improvement (N = 89, MD -0.03 CI -0.5 to 0.4),
indicating no between-group differences. On the whole, there is very little useable data in the few studies meeting inclusion criteria.With only a
few studies meeting inclusion criteria, and with limited useable data in these studies, it is not possible to arrive at definitive conclusions. The
preliminary pattern of evidence suggests that people with early episode schizophrenia treated with typical antipsychotic medications are less likely
to leave the study early, but more likely to experience medication-related side effects. Data are too sparse to assess the effects of antipsychotic
medication on outcomes in early episode schizophrenia.
Cochrane
Database of Systematic Reviews, (6) : CD006374
- Year: 2011
- Problem: Psychosis Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), First episode (psychosis only)
-
Treatment and intervention: Biological Interventions
(any), Typical Antipsychotics (first generation), Atypical Antipsychotics (second
generation)
Eack, S. M., Pogue-Geile, M. F., Greenwald, D. P., Hogarty, S. S., Keshavan, M. S.
Background: Cognitive rehabilitation has emerged as an effective treatment for addressing cognitive
impairments and functional disability in schizophrenia; however, the degree to which changes in various social and non social cognitive processes
translate into improved functioning during treatment remains unclear. This research sought to identify the neurocognitive and social cognitive
mechanisms of functional improvement during a 2 year trial of cognitive enhancement therapy (CET) for early course schizophrenia. Method: Patients in
the early course of schizophrenia were randomly assigned to CET (n = 31) or an enriched supportive therapy control (n = 27) and treated for up to 2
years. A comprehensive neurocognitive assessment battery and the Mayer Salovey Caruso Emotional Intelligence Test (MSCEIT) were completed annually,
along with measures of functioning. Mediator analyses using mixed effects growth models were conducted to examine the effects of neurocognitive and
social cognitive improvement on functional change. Results: Improvements over 2 years in neurocognition and the emotion management branch of the
MSCEIT were found to be significantly related to improved functional outcome in early course schizophrenia patients. Neuro cognitive improvement,
primarily in executive functioning, and social cognitive change in emotion management also mediated the robust effects of CET on functioning.
Conclusions: Improvements in neurocognition and social cognition that result from cognitive rehabilitation are both significant mediators of
functional improvement in early course schizophrenia. Cognitive rehabilitation programs for schizophrenia may need to target deficits in both social
and non social cognition to achieve an optimal functional response. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal
abstract)
Psychological Medicine, 41(6) : 1253-1261
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy, Supportive
therapy
Edwards, J., Cocks, J., Burnett, P., Maud, D., Wong, L., Yuen, H. P., Harrigan, S. M., et-al
Here we report the results of a pilot study investigating
the relative and combined effects of a 12 week course of clozapine and CBT in first-episode psychosis patients with prominent ongoing positive
symptoms following their initial treatment. Patients from our early psychosis service who met the inclusion criteria (n = 48) were randomized to one
of four treatment groups: clozapine, clozapine plus CBT, thioridazine, or thioridazine plus CBT. The degree of psychopathology and functionality of
all participants was measured at baseline then again at 6, 12 and 24 weeks, and the treatment outcomes for each group determined by statistical
analysis. A substantial proportion (52) of those treated with clozapine achieved symptomatic remission, as compared to 35 of those who were treated
with thioridazine. Overall, those who received clozapine responded more rapidly to treatment than those receiving the alternative treatments.
Interestingly, during the early treatment phase CBT appeared to reduce the intensity of both positive and negative symptoms and thus the time taken
to respond to treatment, as well having as a stabilizing effect over time. (copyright) 2011 J. Edwards et al.
Schizophrenia Research & Treatment, :
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Treatment resistant/treatment refractory, First episode (psychosis only)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Findling, Robert L., Kafantaris, Vivian, Pavuluri, Mani, McNamara, Nora K., McClellan, Jon, Frazier, Jean A., Sikich, Linmarie, Kowatch, Robert, Lingler, Jacqui, Faber, Jon, Rowles, Brieana M., Clemons, Traci E., Taylor-Zapata, Perdita
Objective: The primary
goal of this exploratory study was to obtain data that could lead to evidence-based dosing strategies for lithium in children and adolescents
suffering from bipolar I disorder. Methods: Outpatients aged 7 - 17 years meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition,
diagnostic criteria for bipolar I disorder (manic or mixed) were eligible for 8 weeks of open label treatment with lithium in one of three dosing
arms. In Arm I, participants began treatment at a dose of 300 mg of lithium twice daily. The starting dose of lithium in Arms II and III was 300 mg
thrice daily. Patients in Arms I and II could have their dose increased by 300 mg/day, depending on clinical response, at weekly visits. Patients in
Arm III also had mid-week telephone interviews after which they could also have their dose of lithium increased by 300 mg per day. Youths weighing
<30 kg were automatically assigned to ArmI, whereas youths weighing =30 kg were randomly assigned to ArmI, II, or III. Randomization was balanced by
age (7 - 11 years, 12 - 17 years) and sex in approximately equal numbers. A priori response criteria were defined as a Clinical Global Impressions-
Improvement scale score of =2 and a 50% decrease from baseline on the Young Mania Rating Scale. Results: Of the 61 youths [32 males (52.5%)] who
received open-label lithium, 60 youths completed at least 1 week of treatment and returned for a postbaseline assessment. Most patients had a =50%
improvement in Young Mania Rating Scale score, and more than half of the patients (58%) achieved response. Overall, lithium was well tolerated. All
three treatment arms had similar effectiveness, side effect profiles, and tolerability of lithium. Conclusions: On the basis of these results, a
dosing strategy in which pediatric patients begin lithium at a dose of 300 mg thrice daily (with an additional 300 mg increase during the first
week), followed by 300 mg weekly increases until a priori stopping criteria are met, will be used in an upcoming randomized, placebo-controlled
trial. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Journal of Child & Adolescent Psychopharmacology, 21(3) : 195-
205
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Anticonvulsants/mood stabilisers (excl. lithium), Lithium, Service Delivery & Improvement, Other service delivery and improvement
interventions
Crespo-Facorro, Benedicto, Perez-Iglesias, R, Mata, Ignacio, Caseiro, Olalla, Martinez-Garcia,
Obdulia, Pardo, Gema, Ramirez-Bonilla,
MariLuz, Pelayo-Teran, Jose Maria, Vazquez-Barquero, Jose L.
The effectiveness of antipsychotics in preventing relapses and attaining symptomatic remission is a relevant
topic of psychopharmacological research. The purpose of the present study was to compare the relapse and symptomatic remission rates during the first
year of treatment between low doses of haloperidol and SGAs (olanzapine and risperidone) in drug-navØve first-episode non-affective psychosis
individuals. This is a prospective, randomized, open-label study conducted from February 2001 to February 2006. Data for the present investigation
were obtained from a large epidemiologic and 3-year longitudinal intervention program of first-episode psychosis (DSM-IV criteria) conducted at the
University Hospital Marques de Valdecilla, Santander, Spain. One hundred and seventy four patients were randomly assigned to haloperidol (N = 56),
olanzapine (N = 55), or risperidone (N = 63) and followed up for 1 year. Primary effectiveness measures were the time up to relapse and rates of
relapse and symptomatic remission. There were no significant differences in the relapse rate between treatments (11.1% haloperidol; 18.5% olanzapine,
and 13.8% risperidone) (χ 2 = 1.230; p = 0.541) or in the time up to relapse (Log Rank χ 2 = 0.308; p = 0.857). The rates of relapse for adherent
(11.2%) and non-adherent (26.9%) patients were significantly different (χ 2 = 4.215; df = 1; p = 0.040). The remission rate did not differ
significantly between treatment groups (χ 2 = 2.760; p = 0.252) and adherence to medication did not seem to significantly influence remission rates.
We conclude that haloperidol, olanzapine and risperidone show a similar effectiveness in relapse prevention or in remission attainment during the
first year of treatment. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal
of Psychiatric Research, 45(6) : 763-769
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only), Relapse prevention
-
Treatment and intervention: Biological Interventions
(any), Typical Antipsychotics (first generation), Atypical Antipsychotics (second
generation)
Crespo-Facorro, Benedicto, Perez-Iglesias, R, Mata, Ignacio, Ramirez-
Bonilla, MariLuz, Martinez-Garcia,
Obdulia, Pardo-Garcia, Gema, Caseiro, Olalla, Pelayo-Teran, Jose Maria, Vazquez-Barquero, Jose L.
The aim of this study was to investigate the long-
term effectiveness and efficacy of haloperidol, risperidone and olanzapine in first-episode schizophrenia-spectrum disorders. This was a prospective,
randomized, open-label study. Data for the present investigation were obtained from a large epidemiological and 3-year longitudinal intervention
programme of first-episode psychosis conducted at the University Hospital Marques de Valdecilla, Santander, Spain. One hundred and seventy-four
patients were randomly assigned to haloperidol (N = 56), olanzapine (N = 55), or risperidone (N = 63) and followed up for 1 year. The primary
effectiveness measure was all causes of treatment discontinuation. Effectiveness analyses were based on intend-to-treat populations. In addition, an
analysis based on per protocol populations was conducted in the analysis for clinical efficacy. The treatment discontinuation rate for any cause was
higher with haloperidol than with risperidone and olanzapine (œá¬= = 8.517; p = 0.014). The difference in discontinuation rate between risperidone
and olanzapine was not significant (œá¬= = 0.063; p = 0.802). There were no significant advantages of any of the three treatments in reducing the
severity of psychopathology. Risperidone and olanzapine demonstrated higher effectiveness relative to haloperidol, but the three antipsychotics were
equally effective in reducing the severity of psychopathology. Specific clinical programmes and the use of second-generation antipsychotics may
enhance the effectiveness of antipsychotic treatments. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Psychopharmacology, 25(6) : 744-754
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Biological Interventions
(any), Typical Antipsychotics (first generation), Atypical Antipsychotics (second
generation)
Dean, A. J., Bellgrove, M. A., Hall, T., Phan, W. M., Eyles, D. W., Kvaskoff, D., McGrath, J. J.
Epidemiological research links vitamin D status to various brain-related outcomes. However, few trials examine whether
supplementation can improve such outcomes and none have examined effects on cognition. This study examined whether Vitamin D supplementation led to
improvements in diverse measures of cognitive and emotional functioning, and hypothesised that supplementation would lead to improvements in these
outcomes compared to placebo. Healthy young adults were recruited to a parallel-arm, double-blind trial conducted at The University of Queensland.
Participants were randomly allocated to receive Vitamin D (one capsule daily, containing 5000 IU cholecalciferol) or identical placebo capsule for
six weeks. All participants and outcome assessors were blinded to group assignment. Primary outcome measures assessed at baseline and 6 weeks were
working memory, response inhibition and cognitive flexibility. Secondary outcomes were: hallucination-proneness, psychotic-like experiences, and
ratings of depression, anxiety and anger. 128 participants were recruited, randomised and included in primary analyses (vitamin D n = 63; placebo n =
65). Despite significant increases in vitamin D status in the active group, no significant changes were observed in working memory (F = 1.09; p =
0.30), response inhibition (F = 0.82; p = 0.37), cognitive flexibility (F = 1.37; p = 0.24) or secondary outcomes. No serious adverse effects were
reported. Our findings indicate that vitamin D supplementation does not influence cognitive or emotional functioning in healthy young adults. Future
controlled trials in targeted populations of interest are required to determine whether supplementation can improve functioning in these domains.
Australian and New Zealand Clinical Trials Registry; ACTRN12610000318088.
PLoS ONE, 6(11) : e25966
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Eack,
Shaun M., Hogarty, Gerard E., Greenwald, Deborah P., Hogarty, Susan S., Keshavan, Matcheri S.
Objective: To examine the effects of psychosocial cognitive
rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course
schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and
treated for 2 years. Comprehensive data on cognition and employment were collected annually. Results: Individuals treated with CET were significantly
more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of
treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and nonsocial cognition mediated CET effects on
employment. Conclusion: CET can help facilitate employment in early schizophrenia by addressing the cognitive impairments that limit functioning in
the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia.
(PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Research on Social Work Practice, 21(1) : 32-42
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy, Supportive
therapy
Kane, J. M., Hochfeld, M., Meng, X.
Background: Iloperidone (ILO), a mixed D2/5-HT2 antagonist, is
indicated for the treatment of schizophrenia. This analysis evaluated the treatment effects of ILO in patients with early-stage schizophrenia in
short-term trials. Methods: Data were pooled from 4 double-blind, placebo (PBO)-controlled trials (4 or 6 weeks' duration) that enrolled adult
patients with schizophrenia/schizoaffective disorder (schizoaffective patients were excluded from this analysis). This analysis compared efficacy in
patients with early stage ((less-than or equal to)25 years of age or (less-than or equal to)5 years since onset at baseline) vs. non-early stage
schizophrenia. Brief Psychiatric Rating Scale-derived (BPRSd) and Positive and Negative Syndrome Scale Total (PANSS-T) scores were analyzed. To
calculate reductions from baseline, the last observation before Week 4 (1 study) or 6 (3 studies) was carried forward until Week 4 or 6,
respectively, in the intent-to-treat population. To compare reductions between treatments, least squared mean (LSM) change (plus or minus) standard
error (SE) was derived from an analysis of covariance model with treatment, study, early stage, and treatment by early stage as factors; baseline as
a covariate. Results: 1498 Patients were included in this analysis (410 with early stage and 1088 with non-early stage schizophrenia). At Week 4/
Week 6, LSM (plus or minus) SE mean changes (null = P < .05 vs. PBO) in PANSS-T scores among early patients were -8.0 (plus or minus) 2.2/-8.9 (plus
or minus) 2.3 with ILO 4-8 mg/day, -13.4 (plus or minus) 1.9null/-14.0 (plus or minus) 2.1null with ILO 10-16 mg/day, -12.2 (plus or minus) 1.9/-18.0
(plus or minus) 3.2null with ILO 20-24 mg/day, and -7.4 (plus or minus) 1.8/-5.3 (plus or minus) 2.3 with PBO. Significant reductions vs. PBO were
observed in BPRSd (ILO 10-16 mg/day at Weeks 4 and 6, and ILO 20-24 mg/day at Week 6). Corresponding changes in PANSS-T among non-early stage
patients were -7.5 (plus or minus) 1.5/-7.8 (plus or minus) 1.6, -9.6 (plus or minus) 1.2null/-9.7 (plus or minus) 1.3null,-9.8 (plus or minus)
1.4null/-9.4 (plus or minus) 2.8, and-5.0 (plus or minus) 1.0/-5.8 (plus or minus) 1.4, respectively. Significant reductions vs. PBO in non-early
stage patients were also observed in BPRSd (ILO 10-16 mg/day at Weeks 4 and 6, and ILO 20- 24 mg/day at Week 4). Early stage patients responded
numerically better than non-early stage patients, with significance seen with ILO 20-24 mg/day at Week 6 (PANSS-T and BPRSd, P < .05). Conclusion:
These results suggest that ILO is effective for symptom improvement in schizophrenia patients regardless of duration of illness, and that patients
with early stage schizophrenia respond well. Early stage patients responded numerically better than non-early stage patients, with significance seen
with ILO 20-24 mg/day at Week 6. Support: Novartis Pharmaceuticals Corporation.
Schizophrenia Bulletin, 37 : 308
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Gentile, S.
The onset of severe, chronic or
recurrent psychiatric illnesses, such as schizophrenia-spectrum and bipolar disorders, is a dramatic clinical event often detectable during
adolescence and even in childhood. At any age, pharmacotherapy, along with enhancement of social skills and family support, is the mainstay for the
management of such disorders. The aim of this review is to critically analyze findings from randomized controlled trials (RCTs) that have
investigated the clinical utility of second-generation antipsychotics (SGAs) for the treatment of early-onset schizophrenia and bipolar disorders.
Eighteen studies were considered, all of which were unfortunately impaired by methodologic limitations, such as the paucity of long-term data and
lack of a three-arm comparison (SGA vs SGA vs placebo).Nevertheless, the results of this review allow us to suggest the effectiveness of three SGAs
(aripiprazole, olanzapine, and risperidone) in the short-term treatment of both early-onset schizophrenia and bipolar mania, although such agents
show different safety profiles. The use of clozapine should be strictly limited to patients with non-affective, psychotic symptoms who do not respond
to any of these three SGAs. In contrast, the use of quetiapine and ziprasidone in young patients with either affective or non-affective psychosis is
not yet supported by evidence-based information.Given our findings, further studies are urgently required to identify the best treatment option(s)
for pediatric bipolar disorder (especially the depressive phase) and the long-term management of early-onset schizophrenia.
Pediatric Drugs, 13(5) : 291-302
- Year: 2011
- Problem: Bipolar Disorders, Psychosis Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
McGorry, P. D., Cocks, J., Power, P., Burnett, P., Harrigan, S., Lambert, T.
Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms (EPSs) when treated with the doses of
neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less
toxic in this population. Here, we report the results of a biphasic open label trial designed to assess the efficacy, safety, and tolerability of
low-dose (2-4mg/day) risperidone treatment in a group of 96 first-episode nonaffective psychosis patients. At the end of the trial, 62 of patients
met the response criteria although approximately 80 had achieved a response at some time during the study. Reports of EPS remained low, and there
were no dystonic reactions. We conclude that even at a dose of 2mg/day, risperidone was highly effective in reducing acute symptomatology in a real
world sample of young first-episode psychosis patients. (copyright) 2011 Patrick D. McGorry et al.
Schizophrenia
Research & Treatment, :
- Year: 2011
- Problem: Psychosis Disorders
- Type: Controlled clinical trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Girgis, Ragy R., Merrill, David B., Vorel, Stanislav R., Kim, Edward, Portland, Kimberly, You, Min, Pikalov, Andrei, Whitehead,
Richard, Lieberman,
Jeffrey A.
We conducted a secondary analysis of a completed study of the differential efficacy and side effects of aripiprazole versus
haloperidol in early-stage schizophrenia (ESS), a subpopulation of patients which does not include first episode or chronic patients. A subpopulation
of 360 individuals with ESS were identified from a randomized, multi-center, double-blind study of 1294 individuals with schizophrenia at different
stages of illness who were randomized to treatment with aripiprazole (ESS = 237) or haloperidol (ESS = 123) for one year. The primary outcome measure
was response rate based on a 50% reduction of Positive and Negative Syndrome Scale (PANSS) total scores. Secondary outcomes included several efficacy
and safety measures, as well as treatment discontinuation. More individuals in the aripiprazole group (48%) than in the haloperidol group (28%; p <
0.01) completed the study. Response rates were greater in the aripiprazole group (38% [N = 91]) than in the haloperidol group (22% [N = 27]; p <
0.01). Aripiprazole was associated with fewer extrapyramidal side effects. ESS subjects in the haloperidol group were more likely than those in the
aripiprazole group to discontinue the study drug due to an adverse event other than worsening illness (29% and 11%, respectively; p < 0.01), and
efficacy differences were reduced by interventions to mitigate side effects (decreasing antipsychotic dose with or without adding antiparkinsonian
medication). Aripiprazole has a favorable efficacy/safety profile in ESS and appeared to be superior to haloperidol on a number of efficacy and
safety outcomes. However, excessive dosing of the antipsychotic medications, in particular haloperidol, may have played an important role in
accounting for the differences between aripiprazole and haloperidol in this study. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
(journal abstract)
Journal of Psychiatric Research, 45(6) : 756-762
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Typical Antipsychotics (first generation), Atypical Antipsychotics (second
generation)