Antipsychotic response in first-episode schizophrenia: efficacy of high doses and switching

European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology
Ofer AgidGary Remington

Abstract

Clinicians treating schizophrenia routinely employ high doses and/or antipsychotic switching to achieve response. However, little is actually known regarding the value of these interventions in early schizophrenia. Data were gathered from a treatment algorithm implemented in patients with first-episode schizophrenia that employs two antipsychotic trials at increasing doses before clozapine. Patients were initially treated with either olanzapine or risperidone across three dose ranges, (low, full, high), and in the case of suboptimal response were switched to the alternate antipsychotic. We were interested in the value of (a) high dose treatment and (b) antipsychotic switching. A total of 244 patients were evaluated, with 74.5% (184/244) responsive to Trial 1, and only 16.7% (10/60) responsive to Trial 2. Percentage of response for subjects switched from olanzapine to risperidone was 4.0% (1/25) vs. 25.7% (9/35) for those switched from risperidone to olanzapine. High doses yielded a 15.5% response (14.6% for risperidone vs. 16.7% for olanzapine).The present findings concur with other research indicating that response rate to the initial antipsychotic trial in first-episode schizophrenia is robust; thereafter it declines notably....Continue Reading

References

Jul 3, 2004·The British Journal of Psychiatry : the Journal of Mental Science·Diana PerkinsUNKNOWN HGDH Research Group
Aug 25, 2004·The Journal of Clinical Psychiatry·Sheila BottsJose de Leon
Jan 22, 2005·The Australian and New Zealand Journal of Psychiatry·UNKNOWN Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for the Treatment of Schizophren
Sep 21, 2005·The New England Journal of Medicine·Jeffrey A LiebermanUNKNOWN Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators
Apr 6, 2006·The American Journal of Psychiatry·Robin EmsleyRossella Medori
Jun 9, 2006·Progress in Neuro-psychopharmacology & Biological Psychiatry·Hitoshi TakahashiHisashi Higuchi
Nov 17, 2006·The Journal of Clinical Psychiatry·Benedicto Crespo-FacorroJosé Luis Vázquez-Barquero
Nov 18, 2006·Journal of Clinical Psychopharmacology·Josep Maria HaroUNKNOWN SOHO Study Group
Dec 8, 2006·The American Journal of Psychiatry·Susan M EssockJeffrey A Lieberman
Jan 2, 2007·The Journal of Clinical Psychiatry·Robin EmsleyH Jadri Turner
May 24, 2007·International Clinical Psychopharmacology·Corrado BarbuiLuigi Grassi
Jun 15, 2007·Acta Psychiatrica Scandinavica·E SimonsenT McGlashan
Jul 17, 2007·Journal of Clinical Psychopharmacology·Ofer AgidRobert B Zipursky
Oct 25, 2007·Administration and Policy in Mental Health·Michael Joseph Sernyak, Robert Rosenheck
Dec 7, 2007·The Journal of Clinical Psychiatry·Troy A MooreAlexander L Miller
May 2, 2008·Psychological Medicine·P WhittyE O'Callaghan
Nov 11, 2008·Schizophrenia Research·Robert A RosenheckJeffrey Lieberman
Jun 2, 2010·The British Journal of Psychiatry : the Journal of Mental Science·Rebecca Schennach-WolffMichael Riedel
Aug 21, 2010·Acta Psychiatrica Scandinavica·Erik SimonsenT H McGlashan
Jan 7, 2011·The International Journal of Neuropsychopharmacology·Stefan LeuchtJohn M Davis
Sep 2, 2011·Journal of Clinical Psychopharmacology·Alfredo Carlo AltamuraMassimo Carlo Mauri

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Citations

Apr 10, 2014·Evidence-based Mental Health·Markus Dold, Stefan Leucht
Nov 26, 2015·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Daeyoung RohChan-Hyung Kim
Jun 4, 2015·Psychiatry and Clinical Neurosciences·Kotaro Hatta
Feb 5, 2014·European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology·Maxine X PatelStephen J Cooper
May 23, 2014·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Kotaro Hatta, Hiroto Ito
Aug 25, 2016·Neurology and Therapy·Benedicto Crespo-FacorroJacqueline Mayoral-van Son
May 12, 2018·The Cochrane Database of Systematic Reviews·Myrto T SamaraStefan Leucht
May 12, 2018·The Cochrane Database of Systematic Reviews·Myrto T SamaraStefan Leucht
Sep 16, 2018·Acta Psychiatrica Scandinavica·C Okhuijsen-PfeiferJ J Luykx
Nov 20, 2016·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Euitae KimJun Soo Kwon
Dec 10, 2019·Postgraduate Medicine·Amir M MeftahJoshua T Kantrowitz
Jul 1, 2021·Scientific Reports·Verónica GamónGabriel Sanfélix-Gimeno
Aug 6, 2021·Behavioural Brain Research·Gary RemingtonOfer Agid

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