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Effectiveness of antipsychotic maintenance therapy with quetiapine in comparison with risperidone and olanzapine in routine schizophrenia treatment: results of a prospective observational trial

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Abstract

Objective of this observational trial is to examine the effects of quetiapine in comparison with olanzapine and risperidone on clinical outcomes and quality of life in patients with schizophrenia and schizoaffective disorder in routine care. 374 adult persons with schizophrenia or schizoaffective disorder prescribed antipsychotic maintenance therapy with quetiapine, olanzapine, or risperidone at discharge from inpatient treatment were included. Clinical and psychosocial outcomes were assessed before discharge and at 6, 12, 18, and 24 months. Statistical analyses were conducted by mixed-effects regression models for longitudinal data. The propensity score method was used to control for selection bias. Patients discharged on olanzapine had significantly lower hospital readmissions than those receiving quetiapine or risperidone. The average chlorpromazine equivalent dose of quetiapine was higher than in patients treated with olanzapine or risperidone. No further significant differences between treatment groups were found. Quetiapine and risperidone are less effective in preventing the need for psychiatric inpatient care than olanzapine, and higher chlorpromazine equivalent doses of quetiapine are needed to obtain clinical effects similar to those of olanzapine and risperidone.

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Acknowledgments

The ELAN study was funded as an investigator-initiated research project by a grant from AstraZeneca Deutschland to the University of Tübingen (Project Nr. 229/2004V—Version 2, 27.09.04). AstraZeneca had no role in the development of the research questions, the design of the study, the collection, analyses and interpretation of data, and the writing of the manuscript. AstraZeneca had the right to comment on the final draft of the article before the submission to the journal. We wish to thank all participants who participated in the study. In addition, we thank Max Schmauß, Jochen Bügler, and Frank Schwärzler for supporting the patient recruitment. We also thank Heike Wiesner, Filiz Özfirat, Tanja Gieselmann, and Simone Triem for data collection and data entry and Ildiko Baumgartner for her work in processing data. We also thank Juan Valdes-Stauber for his advice in computing CPZEQ equivalent dosages.

Conflict of interest

The authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy II, BKH Günzburg, Ulm University, Ludwig-Heilmeyer-Str.-2, 89312, Günzburg, Germany

    Reinhold Kilian, Prisca Weiser, Karel Frasch & Thomas Becker

  2. Department of Psychiatry and Psychotherapy I, Zentrum für Psychiatrie Südwürttemberg, Ulm University, Weissenau, Germany

    Tilman Steinert, Susanne Jaeger & Carmen Pfiffner

  3. Department of Forensic Psychiatry and Psychotherapy, Bezirksklinikum Regensburg, Regensburg, Germany

    Wiltrud Schepp

  4. Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany

    Gerhard W. Eschweiler & Gerhard Längle

  5. Danuvius Klinik GmbH, Pfaffenhofen, Germany

    Thomas Messer

  6. Klinik für Psychiatrie und Psychotherapie, Zentrum für Psychiatrie Südwürttemberg, Zwiefalten, Germany

    Daniela Croissant & Gerhard Längle

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  1. Reinhold Kilian
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  2. Tilman Steinert
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Correspondence to Reinhold Kilian.

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Kilian, R., Steinert, T., Schepp, W. et al. Effectiveness of antipsychotic maintenance therapy with quetiapine in comparison with risperidone and olanzapine in routine schizophrenia treatment: results of a prospective observational trial. Eur Arch Psychiatry Clin Neurosci 262, 589–598 (2012). https://doi.org/10.1007/s00406-012-0316-9

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  • DOI: https://doi.org/10.1007/s00406-012-0316-9

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