Artículo
Antipsychotic Treatment Effectiveness in First Episode of Psychosis: PAFIP 3-Year Follow-Up Randomized Clinical Trials Comparing Haloperidol, Olanzapine, Risperidone, Aripiprazole, Quetiapine, and Ziprasidone
Autor/es | Gómez-Revuelta, Marcos
Pelayo-Terán, José María Juncal-Ruiz, María Vázquez-Bourgon, Javier Suárez-Pinilla, Paula Romero-Jiménez, Rodrigo Crespo Facorro, Benedicto |
Departamento | Universidad de Sevilla. Departamento de Psiquiatría |
Fecha de publicación | 2020 |
Fecha de depósito | 2023-06-21 |
Publicado en |
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Resumen | Background: Different effectiveness profiles among antipsychotics may be a key point to optimize treatment in patients suffering a first episode of psychosis to impact on long-term outcome. The aim of this study is to ... Background: Different effectiveness profiles among antipsychotics may be a key point to optimize treatment in patients suffering a first episode of psychosis to impact on long-term outcome. The aim of this study is to compare the clinical effectiveness of olanzapine, risperidone, haloperidol, aripiprazole, ziprasidone, and quetiapine in the treatment of first episode of psychosis at 3-year follow-up. Method: From February 2001 to January 2011, 2 phases of a prospective, randomized, open-label study were undertaken. A total of 376 first-episode drug-naïve patients were randomly assigned to olanzapine (n = 55), risperidone (n = 63), haloperidol (n = 56), aripiprazole (n = 78), ziprasidone (n = 62), or quetiapine (n = 62) and followed up for 3 years. The primary effectiveness measure was all cause of treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted in the analysis for clinical efficacy. Results: The overall dropout rate at 3 years reached 20.75%. Treatment discontinuation rates were significantly different among treatment groups (olanzapine = 69.09, risperidone = 71.43, aripiprazole = 73.08%, ziprasidone = 79.03%, haloperidol = 89.28%, and quetiapine = 95.53%) (χ2 = 79.86; P = .000). Statistically significant differences in terms of lack of efficacy, adherence, and tolerability were observed among treatment groups along the 3-year follow-up, determining significant differences in time to all-cause discontinuation (log-rank = 92.240; P = .000). Significant differences between treatments were found in the categories of sleepiness/sedation, increased sleep duration, akinesia, weight gain, ejaculatory dysfunction, extrapyramidal-symptoms, and amenorrhea. Conclusions: Olanzapine, risperidone, and aripiprazole presented advantages for the first-line treatment of first episode of psychosis in terms of effectiveness. Identifying different discontinuation patterns may contribute to optimize treatment selection after first episode of psychosis.ClinicalTrials.gov Identifier: NCT02526030 https://clinicaltrials.gov/show/NCT02526030. |
Agencias financiadoras | AstraZeneca Bristol-Myers Squibb Fundacion Marques de Valdecilla Gerencia Regional de Salud de Castilla y Leon Johnson Johnson Pfizer Plan Nacional de Drogas Research SENY Fundacio |
Identificador del proyecto | API07/011
INT/M/04/17 2005-Orden sco/3246/2004 CI 2005-0308007 |
Cita | Gómez-Revuelta, M., Pelayo-Terán, J.M., Juncal-Ruiz, M., Vázquez-Bourgon, J., Suárez-Pinilla, P., Romero-Jiménez, R. y Crespo Facorro, B. (2020). Antipsychotic Treatment Effectiveness in First Episode of Psychosis: PAFIP 3-Year Follow-Up Randomized Clinical Trials Comparing Haloperidol, Olanzapine, Risperidone, Aripiprazole, Quetiapine, and Ziprasidone. International Journal of Neuropsychopharmacology (IJNP), 23 (4), 217-229. https://doi.org/10.1093/ijnp/pyaa004. |
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