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Effectiveness of maintenance treatments with atypical and typical antipsychotics in stable schizophrenia with early stage: 1-year naturalistic study

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Abstract

Rationale

The relative effectiveness of the atypical antipsychotic drugs and conventional agents in patients with early-stage schizophrenia has not been comprehensively determined.

Objectives

The aim of our study was to evaluate the efficacy and safety of seven antipsychotic drugs for the maintenance treatment in patients with early-stage schizophrenia.

Methods

In a 12-month open-label, prospective observational, multicenter study, 1,133 subjects with schizophrenia or schizophreniform disorder within 5 years of onset were monotherapy with chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine, or aripiprazole. The primary measure was the rate of treatment discontinuation for any reason. Secondary outcomes included measures for clinical and functional outcomes and tolerability.

Results

The percentage of patients discontinued treatment within 12 months was 41.4% for chlorpromazine, 39.5% for sulpiride, 36.7% for clozapine, 40.2% for risperidone, 39.6% for olanzapine, 46.9% for quetiapine, and 40.2% for aripiprazole, a nonsignificant difference (p = 0.717); there were no significant differences among these seven treatments on discontinuation due to relapse, intolerability, patient decision, or nonadherence (all p values ≥ 0.260). Extrapyramidal symptoms were more prominent in chlorpromazine and sulpiride treatment groups. Anticholinergic side effects were most common with clozapine and chlorpromazine. Weight gain was most common with olanzapine and clozapine.

Conclusions

The efficacy of seven antipsychotic medications for the maintenance treatment appeared similar in early-stage schizophrenia. With regard to the high dropout rate and side effects, special programs are needed to keep efficacy and safety of antipsychotics maintenance treatment for schizophrenia with early stage

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Acknowledgments

This research was supported by the National Key Technologies R&D Program in the 10th 5-year-plan of China (grant no. 2004BA720A22), by the National Natural Science Foundation of China (grant no. 30630062 and 30900485), and by the National Basic Research Program of China (grant no. 2010CB529601).

Author information

Authors and Affiliations

  1. Institute of Mental Health, the Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, People’s Republic of China

    Xiaofeng Guo, Maosheng Fang, Jinguo Zhai & Jingping Zhao

  2. Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China

    Maosheng Fang

  3. Chongqing Mental Health Center, Chongqing, China

    Bo Wang

  4. Beijing Anding Hospital Affiliated to Capital Medical University, Beijing, China

    Chuanyue Wang

  5. Psychiatric Hospital of Jiangxi Province, Nanchang, China

    Bin Hu

  6. Mental Health Center of West China Hospital, Sichuan University, Chengdu, China

    Xueli Sun

  7. Mental Hospital of Henan Province, Xinxiang, China

    Luxian Lv

  8. Shanghai Mental Health Center, Shanghai, China

    Zheng Lu

  9. Guangzhou Brain Hospital, Guangzhou, China

    Cui Ma

  10. Hunan Brain Hospital, Changsha, China

    Tiansheng Guo

  11. Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China

    Shiping Xie

  12. Department of Psychiatry, University of California, San Diego, USA

    Elizabeth W. Twamley & Hua Jin

Authors
  1. Xiaofeng Guo
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  2. Maosheng Fang
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  4. Bo Wang
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  5. Chuanyue Wang
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  6. Bin Hu
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  7. Xueli Sun
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  8. Luxian Lv
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  9. Zheng Lu
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  10. Cui Ma
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  11. Tiansheng Guo
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  12. Shiping Xie
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  13. Elizabeth W. Twamley
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  14. Hua Jin
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  15. Jingping Zhao
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Corresponding author

Correspondence to Jingping Zhao.

Additional information

Clinical Trials.gov Identifier: NCT00654576

Guo and Fang contributed equally to the study.

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Guo, X., Fang, M., Zhai, J. et al. Effectiveness of maintenance treatments with atypical and typical antipsychotics in stable schizophrenia with early stage: 1-year naturalistic study. Psychopharmacology 216, 475–484 (2011). https://doi.org/10.1007/s00213-011-2242-3

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  • DOI: https://doi.org/10.1007/s00213-011-2242-3

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