Aripiprazole, Ziprasidone and Quetiapine in the treatment of first-episode nonaffective psychosis: A 12-week randomized, flexible-dose, open-label trial

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• 作者：Benedicto Crespo-Facorro^a ; ^b ; ^{bcfacorro@humv.es} ; Victor Ortiz-Garcí ; a de la Foz^a ; ^b ; Ignacio Mata^a ; ^b ; Rosa Ayesa-Arriola^a ; ^b ; Paula Suarez-Pinilla^a ; Elsa M. Valdizan^b ; ^d ; José ; Luis Vá ; zquez-Barquero^a ; ^b ; Rocí ; o Pé ; rez-Iglesias^b ; ^c
• 关键词：Antipsychotic agents ; Schizophrenia ; Adverse effects ; Psychotherapeutic processes
• 刊名：Schizophrenia Research
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：147
• 期：2-3
• 页码：375-382
• 全文大小：584 K

文摘

Background

Differences among antipsychotics in terms of effectiveness have turned out to be a topic of increasing research interest, although comparisons between the different second generation antipsychotics (SGAs) are scarce. We aimed to compare the clinical effectiveness in the short-term of Aripiprazole, Ziprasidone and Quetiapine in the treatment of first-episode schizophrenia-spectrum disorders.

Method

From October 2005 to January 2011, a prospective, randomized, open-label study was undertaken. 202 first-episode drug-na?ve patients were randomly assigned to Aripiprazole (N = 78), Ziprasidone (N = 62), or Quetiapine (N = 62) and followed-up for 3 months. The primary effectiveness measure was all-cause of treatment discontinuation. In addition, an analysis based on intention-to-treat populations was conducted in the analysis for clinical efficacy.

Results

The overall dropout rate at 3 months was small (13.86 % ). The treatment discontinuation rate differed significantly between treatment groups (Aripiprazole = 23.1 % , Ziprasidone = 37.1 % and Quetiapine = 61.3 % ) (¦Ö² = 21.334; p < 0.001). Insufficient efficacy in the group of Quetiapine is the main reason for discontinuation rate differences (¦Ö² = 20.223; p < 0.001). The mean time to all-cause discontinuation was significantly different between groups (LogRank = 23.467 p < 0.001). Aripiprazole and Quetiapine were associated with a greater depressive symptoms improvement (p = 0.043). The profile of side-effects varies between treatments. Patients on Quetiapine were less likely to be prescribed hypnotics.

Conclusions

Patients treated with Quetiapine had a higher risk of treatment discontinuation in the short-term after a first episode due to insufficient efficacy. Establishing differences between SGAs may help clinicians in prescribing decisions for the treatment of individuals presenting with first-episode schizophrenia.