Journal article
The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: Results from the CATIE study
Schizophrenia research, Vol.100(1), pp.39-52
2008
DOI: 10.1016/j.schres.2007.11.034
PMID: 18191383
Abstract
This double-blind study compared a second generation (atypical) antipsychotic drugs compared to a representative older agent for patients with schizophrenia who use or avoid illicit substances.
Schizophrenic subjects were recruited at 57 U.S. sites and randomly assigned to olanzapine, perphenazine, quetiapine, risperidone or ziprasidone for up to 18 months. The primary aim of this analysis was to delineate differences between the overall effectiveness of these five treatments among patients who used or did not use illicit substances.
There were no significant differences between treatment groups in time to all-cause treatment discontinuation
among patients who use illicit drugs (median 3.3 to 6.8 months).
Among non-users time to treatment discontinuation was significantly longer for patients treated with olanzapine (median 13.0 months) than perphenazine ( 5.9 months), risperidone (5.6 months), or quetiapine (5.0 months); time to discontinuation for ziprasidone (4.3 months) was even shorter, although the latter difference was not significant. The difference between risperidone and quetiapine, although small, was significant. All remaining differences were non-significant. Similar results were found for discontinuation due to inefficacy. There were no differences between illicit users and non-users in symptom reduction and global improvement, after adjustment for differential duration of treatment. Differences in discontinuation results were attenuated by non-compliance, but the trends persisted after controlling for treatment compliance.
Among patients with chronic schizophrenia who avoid use of illicit drugs, olanzapine was more effective than other antipsychotics as reflected by longer time to all-cause discontinuation, but illicit substance abuse attenuated this advantage, reinforcing the need for concurrent substance abuse treatment.
Details
- Title: Subtitle
- The effectiveness of antipsychotic medications in patients who use or avoid illicit substances: Results from the CATIE study
- Creators
- Marvin S Swartz - Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC, United StatesH. Ryan Wagner - Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC, United StatesJeffrey W Swanson - Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC, United StatesT. Scott Stroup - Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, NC, United StatesJoseph P McEvoy - Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC, United StatesFred Reimherr - Department of Psychiatry, University of Utah Medical Center, Salt Lake City, UT, United StatesDel D Miller - Department of Psychiatry, University of Iowa School of Medicine, Iowa City, IA, United StatesMark McGee - Appalachian Behavioral Healthcare System, Athens OH, United StatesAhsan Khan - Psychiatric Research Institute, Wichita KS, United StatesJose M Canive - Department of Psychiatry, Albuquerque Veteran’s Administration Medical Center and the University of New Mexico, Albequerque, NM, United StatesSonia M Davis - Quintiles Inc., Research Triangle Park, NC, United StatesJohn K Hsiao - Division of Services and Intervention Research, National Institute of Mental Health, National Institutes of Health, Bethesda, United StatesJeffrey A Lieberman - Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York, United StatesClinical Antipsychotic Trials of Intervention Effectiveness Investigators
- Resource Type
- Journal article
- Publication Details
- Schizophrenia research, Vol.100(1), pp.39-52
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.schres.2007.11.034
- PMID
- 18191383
- ISSN
- 0920-9964
- eISSN
- 1573-2509
- Language
- English
- Date published
- 2008
- Academic Unit
- Psychiatry
- Record Identifier
- 9984003423302771
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