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What CATIE found: results from the schizophrenia trial.
Psychiatr Serv. 2008 May; 59(5):500-6.PS

Abstract

The authors provide an overview of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) sponsored by the National Institute of Mental Health. CATIE was designed to compare a proxy first-generation antipsychotic, perphenazine, to several newer drugs. In phase 1 of the trial, consenting patients were randomly assigned to receive olanzapine, perphenazine, quetiapine, risperidone, or ziprasidone for up to 18 months on a double-blind basis. Patients with tardive dyskinesia were excluded from being randomly assigned to perphenazine and were assigned to one of the four second-generation antipsychotics in phase 1A. Clozapine was included in phase 2 of the study. Overall, olanzapine had the longest time to discontinuation in phase 1, but it was associated with significant weight and metabolic concerns. Perphenazine was not significantly different in overall effectiveness, compared with quetiapine, risperidone, and ziprasidone. Also, perphenazine was found to be the most cost-effective drug. Clozapine was confirmed as the most effective drug for individuals with a poor symptom response to previous antipsychotic drug trials, although clozapine was also associated with troublesome adverse effects. There were no differences in neurocognitive or psychosocial functioning in response to medications. Subsequent randomizations suggest that a poor response to an initial medication may mean that a different medication will be more effective or better tolerated. Although the CATIE results are controversial, they are broadly consistent with most previous antipsychotic drug trials and meta-analyses; however, the results may not generalize well to patients at high risk of tardive dyskinesia. Patient characteristics and clinical circumstances affected drug effectiveness; these patient factors are important in making treatment choices.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA. swart001@mc.duke.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18451005

Citation

Swartz, Marvin S., et al. "What CATIE Found: Results From the Schizophrenia Trial." Psychiatric Services (Washington, D.C.), vol. 59, no. 5, 2008, pp. 500-6.
Swartz MS, Stroup TS, McEvoy JP, et al. What CATIE found: results from the schizophrenia trial. Psychiatr Serv. 2008;59(5):500-6.
Swartz, M. S., Stroup, T. S., McEvoy, J. P., Davis, S. M., Rosenheck, R. A., Keefe, R. S., Hsiao, J. K., & Lieberman, J. A. (2008). What CATIE found: results from the schizophrenia trial. Psychiatric Services (Washington, D.C.), 59(5), 500-6. https://doi.org/10.1176/ps.2008.59.5.500
Swartz MS, et al. What CATIE Found: Results From the Schizophrenia Trial. Psychiatr Serv. 2008;59(5):500-6. PubMed PMID: 18451005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What CATIE found: results from the schizophrenia trial. AU - Swartz,Marvin S, AU - Stroup,T Scott, AU - McEvoy,Joseph P, AU - Davis,Sonia M, AU - Rosenheck,Robert A, AU - Keefe,Richard S E, AU - Hsiao,John K, AU - Lieberman,Jeffrey A, PY - 2008/5/3/pubmed PY - 2008/9/18/medline PY - 2008/5/3/entrez SP - 500 EP - 6 JF - Psychiatric services (Washington, D.C.) JO - Psychiatr Serv VL - 59 IS - 5 N2 - The authors provide an overview of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) sponsored by the National Institute of Mental Health. CATIE was designed to compare a proxy first-generation antipsychotic, perphenazine, to several newer drugs. In phase 1 of the trial, consenting patients were randomly assigned to receive olanzapine, perphenazine, quetiapine, risperidone, or ziprasidone for up to 18 months on a double-blind basis. Patients with tardive dyskinesia were excluded from being randomly assigned to perphenazine and were assigned to one of the four second-generation antipsychotics in phase 1A. Clozapine was included in phase 2 of the study. Overall, olanzapine had the longest time to discontinuation in phase 1, but it was associated with significant weight and metabolic concerns. Perphenazine was not significantly different in overall effectiveness, compared with quetiapine, risperidone, and ziprasidone. Also, perphenazine was found to be the most cost-effective drug. Clozapine was confirmed as the most effective drug for individuals with a poor symptom response to previous antipsychotic drug trials, although clozapine was also associated with troublesome adverse effects. There were no differences in neurocognitive or psychosocial functioning in response to medications. Subsequent randomizations suggest that a poor response to an initial medication may mean that a different medication will be more effective or better tolerated. Although the CATIE results are controversial, they are broadly consistent with most previous antipsychotic drug trials and meta-analyses; however, the results may not generalize well to patients at high risk of tardive dyskinesia. Patient characteristics and clinical circumstances affected drug effectiveness; these patient factors are important in making treatment choices. SN - 1075-2730 UR - https://www.unboundmedicine.com/medline/citation/18451005/What_CATIE_found:_results_from_the_schizophrenia_trial_ L2 - https://ps.psychiatryonline.org/doi/10.1176/ps.2008.59.5.500?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -