Effectiveness of second-generation antipsychotics with
acute-phase schizophrenia
Schizophrenia Research, 07/22/09
Hatta K et al. – Olanzapine and risperidone are superior to quetiapine and aripiprazole for the acute treatment of psychosis in hospitalized patients.
Methods- performed a rater–blinded, randomized controlled trial of four SGAs in 15 psychiatric emergency sites.
- Eligible patients were 18–64 years old and met diagnostic criteria for schizophrenia, acute schizophrenia–like psychotic disorder, or schizoaffective disorder.
- A final total of 78 patients were randomly assigned by means of sealed envelopes to receive risperidone (3–12 mg/day; n = 20), olanzapine (10–20 mg/day; n = 17), quetiapine (300–750 mg/day; n = 20), or aripiprazole (12–30 mg/day; n = 21), with follow–up at 8 weeks.
- The primary outcome measure was all–cause treatment discontinuation.
- Overall, 37% (29/78) of patients discontinued the study medication before 8 weeks: 25% for risperidone; 12% for olanzapine; 55% for quetiapine; and 52% for aripiprazole.
- Time to treatment discontinuation for any cause was significantly longer in the olanzapine group than in the quetiapine (p = 0.006) or aripiprazole (p = 0.008) groups, but not compared to the risperidone group (p = 0.32).
- Time to treatment discontinuation was significantly longer in the risperidone group than in the quetiapine group (p = 0.048), but not compared to the aripiprazole group (p = 0.062).
- However, the rate of p.r.n. intramuscular haloperidol use was significantly higher in the aripiprazole group than in other groups (p = 0.029)
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