Journal article
Treatment Outcomes of Patients With Tardive Dyskinesia and Chronic Schizophrenia
The journal of clinical psychiatry, Vol.72(3), pp.295-303
03/01/2011
DOI: 10.4088/JCP.09m05793yel
PMCID: PMC3825701
PMID: 20816031
Abstract
Objective: We compared the response to antipsychotic treatment between patients with and without tardive dyskinesia (TD) and examined the course of TD.
Method: This analysis compared 200 patients with DSM-IV defined schizophrenia and TD and 997 patients without TD, all of whom were randomly assigned to receive one of 4 second-generation antipsychotics. The primary clinical outcome measure was time to all-cause treatment discontinuation, and the primary measure for evaluating the course of TD was change from baseline in Abnormal Involuntary Movement Scale (AIMS) score. Kaplan-Meier survival analysis and Cox proportional hazards regression models were used to compare treatment discontinuation between groups. Changes in Positive and Negative Syndrome Scale (PANSS) and neurocognitive scores were compared using mixed models and analysis of variance. Treatment differences between drugs in AIMS scores and all-cause discontinuation were examined for those with TD at baseline. Percentages of patients meeting criteria for TD postbaseline or showing changes in AIMS scores were evaluated with chi(2) tests. Data were collected from January 2001 to December 2004.
Results: Time to treatment discontinuation for any cause was not significantly different between the TD and non-TD groups (chi(2)(1) = 0.11, P=.743). Changes in PANSS scores were not significantly different (F-1,F-974 = 0.82, P=.366), but patients with TD showed less improvement in neurocognitive scores (F-1,F-359=6.53, P=.011). Among patients with TD, there were no significant differences between drugs in the decline in AIMS scores (F-3,F-151 = 0.32, P=.811); 55% met criteria for TD at 2 consecutive visits postbaseline, 76% met criteria for TD at some or all postbaseline visits, 24% did not meet criteria for TD at any subsequent visit, 32% showed a >= 50% decrease in AIMS score, and 7% showed a >= 50% increase in AIMS score.
Conclusions: Schizophrenia patients with and without TD were similar in time to discontinuation of treatment for any cause and improvement in psychopathology, but differed in neurocognitive response. There were no significant differences between treatments in the course of TD, with most patients showing either persistence of or fluctuation in observable symptoms. Trial Registration: clinicaltrials.gov Identifier: NCT00014001 J Clin Psychiatry 2011;72(3):295-303 (C) Copyright 2010 Physicians Postgraduate Press, Inc.
Details
- Title: Subtitle
- Treatment Outcomes of Patients With Tardive Dyskinesia and Chronic Schizophrenia
- Creators
- Stanley N. Caroff - University of PennsylvaniaVicki G. Davis - University of North Carolina at Chapel HillDel D. Miller - University of IowaSonia M. Davis - IQVIARobert A. Rosenheck - Yale UniversityJoseph P. McEvoy - Duke UniversityE. Cabrina Campbell - University of PennsylvaniaBruce L. Saltz - Mental Health Advocates, Inc.Silvana Riggio - Icahn School of Medicine at Mount SinaiMiranda H. Chakos - SUNY Downstate Medical CenterMarvin S. Swartz - Duke UniversityRichard S. E. Keefe - Duke UniversityT. Scott Stroup - Columbia UniversityJeffrey A. Lieberman - Columbia UniversityCATIE Investigators
- Resource Type
- Journal article
- Publication Details
- The journal of clinical psychiatry, Vol.72(3), pp.295-303
- Publisher
- Physicians Postgraduate Press
- DOI
- 10.4088/JCP.09m05793yel
- PMID
- 20816031
- PMCID
- PMC3825701
- ISSN
- 0160-6689
- eISSN
- 1555-2101
- Number of pages
- 9
- Grant note
- AstraZeneca Pfizer Bristol-Myers Squibb NO1 MH90001 / National Institute of Mental Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) National Institute of Mental Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) Singapore National Medical Research Council; National Medical Research Council, Singapore Organon Novartis Janssen; Johnson & Johnson; Johnson & Johnson USA; Janssen Biotech Inc Wyeth Indevus Allon R01MH080015 / NATIONAL INSTITUTE OF MENTAL HEALTH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) Forest Foundation for the National Institute of Health Ortho-McNeil Neurologics Cephalon Solvay; Solvay SA Eli Lilly Dainippon Sumitomo; Dainippon Sumitomo Pharma Co., Ltd. Department of Veterans Affairs, Veterans Health Administration, Office of Research Development; US Department of Veterans Affairs Roche; Roche Holding
- Language
- English
- Date published
- 03/01/2011
- Academic Unit
- Psychiatry
- Record Identifier
- 9984280868902771
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