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Long-term antipsychotic monotherapy for schizophrenia: disease burden and comparative outcomes for patients treated with olanzapine, quetiapine, risperidone, or haloperidol monotherapy in a pan-continental observational study.
J Clin Psychiatry. 2008 Dec; 69(12):1901-15.JC

Abstract

OBJECTIVE

Noninterventional, naturalistic studies facilitate examination of current clinical practices and provide an understanding of the impact of the biopsychosocial aspects of schizophrenia. This article describes disease burden and patient outcomes, with an emphasis on the comparative effectiveness and tolerability of antipsychotic monotherapy.

METHOD

Outpatients initiating or changing antipsychotic therapy for DSM-IV- or ICD-10-defined schizophrenia (N = 7658) were allocated to olanzapine or nonolanzapine cohorts (November 2000 to December 2001). Treatment was at the psychiatrist's discretion, including flexible dosing and use of concomitant therapies and medications, with assessments at 0, 3, 6, 12, 18, 24, 30, and 36 months. Longitudinal clinical, pharmacologic, functional, and social data were collected over 36 months across 27 countries.

RESULTS

At entry, 76% of patients were initiated/switched to antipsychotic monotherapy, most commonly with olanzapine (N = 3222), risperidone (N = 1117), quetiapine (N = 189), or haloperidol (N = 257). Patients prescribed olanzapine were more likely to maintain their baseline monotherapy (p < .001) and did so for a longer period (p < .001) compared with other antipsychotics. Median time to discontinuation (in months) was as follows: olanzapine 30.0, risperidone 23.1, quetiapine 13.9, haloperidol 12.5. Olanzapine-treated patients were also more likely to respond, and did so more rapidly than patients on other monotherapies (p < .001). Response data were also favorable for risperidone; median time to response (in months) was as follows: olanzapine 5.2, risperidone 6.3, quetiapine 11.3, haloperidol 11.7. Treatment-emergent adverse events varied: olanzapine patients had less favorable odds for significant weight gain (p < .001); haloperidol patients, for motor dysfunction (p < or = .002).

CONCLUSION

These naturalistic data from less-studied outpatient communities highlight the variability in clinical and functional outcomes associated with long-term antipsychotic treatment.

Authors+Show Affiliations

Eli Lilly and Co., GmbH, Vienna, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19012820

Citation

Dossenbach, Martin, et al. "Long-term Antipsychotic Monotherapy for Schizophrenia: Disease Burden and Comparative Outcomes for Patients Treated With Olanzapine, Quetiapine, Risperidone, or Haloperidol Monotherapy in a Pan-continental Observational Study." The Journal of Clinical Psychiatry, vol. 69, no. 12, 2008, pp. 1901-15.
Dossenbach M, Pecenak J, Szulc A, et al. Long-term antipsychotic monotherapy for schizophrenia: disease burden and comparative outcomes for patients treated with olanzapine, quetiapine, risperidone, or haloperidol monotherapy in a pan-continental observational study. J Clin Psychiatry. 2008;69(12):1901-15.
Dossenbach, M., Pecenak, J., Szulc, A., Irimia, V., Anders, M., Logozar-Perkovic, D., Peciukaitiene, D., Kotler, M., Smulevich, A. B., West, T. M., Lowry, A. J., & Treuer, T. (2008). Long-term antipsychotic monotherapy for schizophrenia: disease burden and comparative outcomes for patients treated with olanzapine, quetiapine, risperidone, or haloperidol monotherapy in a pan-continental observational study. The Journal of Clinical Psychiatry, 69(12), 1901-15.
Dossenbach M, et al. Long-term Antipsychotic Monotherapy for Schizophrenia: Disease Burden and Comparative Outcomes for Patients Treated With Olanzapine, Quetiapine, Risperidone, or Haloperidol Monotherapy in a Pan-continental Observational Study. J Clin Psychiatry. 2008;69(12):1901-15. PubMed PMID: 19012820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term antipsychotic monotherapy for schizophrenia: disease burden and comparative outcomes for patients treated with olanzapine, quetiapine, risperidone, or haloperidol monotherapy in a pan-continental observational study. AU - Dossenbach,Martin, AU - Pecenak,Jan, AU - Szulc,Agata, AU - Irimia,Victoria, AU - Anders,Martin, AU - Logozar-Perkovic,Dusanka, AU - Peciukaitiene,Dalia, AU - Kotler,Moshe, AU - Smulevich,Anatoly B, AU - West,Teena M, AU - Lowry,Amanda J, AU - Treuer,Tamas, Y1 - 2008/09/09/ PY - 2008/04/01/received PY - 2008/07/01/accepted PY - 2008/11/18/pubmed PY - 2009/3/7/medline PY - 2008/11/18/entrez SP - 1901 EP - 15 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 69 IS - 12 N2 - OBJECTIVE: Noninterventional, naturalistic studies facilitate examination of current clinical practices and provide an understanding of the impact of the biopsychosocial aspects of schizophrenia. This article describes disease burden and patient outcomes, with an emphasis on the comparative effectiveness and tolerability of antipsychotic monotherapy. METHOD: Outpatients initiating or changing antipsychotic therapy for DSM-IV- or ICD-10-defined schizophrenia (N = 7658) were allocated to olanzapine or nonolanzapine cohorts (November 2000 to December 2001). Treatment was at the psychiatrist's discretion, including flexible dosing and use of concomitant therapies and medications, with assessments at 0, 3, 6, 12, 18, 24, 30, and 36 months. Longitudinal clinical, pharmacologic, functional, and social data were collected over 36 months across 27 countries. RESULTS: At entry, 76% of patients were initiated/switched to antipsychotic monotherapy, most commonly with olanzapine (N = 3222), risperidone (N = 1117), quetiapine (N = 189), or haloperidol (N = 257). Patients prescribed olanzapine were more likely to maintain their baseline monotherapy (p < .001) and did so for a longer period (p < .001) compared with other antipsychotics. Median time to discontinuation (in months) was as follows: olanzapine 30.0, risperidone 23.1, quetiapine 13.9, haloperidol 12.5. Olanzapine-treated patients were also more likely to respond, and did so more rapidly than patients on other monotherapies (p < .001). Response data were also favorable for risperidone; median time to response (in months) was as follows: olanzapine 5.2, risperidone 6.3, quetiapine 11.3, haloperidol 11.7. Treatment-emergent adverse events varied: olanzapine patients had less favorable odds for significant weight gain (p < .001); haloperidol patients, for motor dysfunction (p < or = .002). CONCLUSION: These naturalistic data from less-studied outpatient communities highlight the variability in clinical and functional outcomes associated with long-term antipsychotic treatment. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/19012820/Long_term_antipsychotic_monotherapy_for_schizophrenia:_disease_burden_and_comparative_outcomes_for_patients_treated_with_olanzapine_quetiapine_risperidone_or_haloperidol_monotherapy_in_a_pan_continental_observational_study_ L2 - http://www.psychiatrist.com/jcp/article/pages/2008/v69n12/v69n1208.aspx DB - PRIME DP - Unbound Medicine ER -