title: Relapse according to antipsychotic treatment in schizophrenic patients: a propensity-adjusted analysis.
abstract: OBJECTIVE
  To compare the rate of relapse as a function of antipsychotic treatment (monotherapy vs. polypharmacy) in schizophrenic patients over a 2-year period.
  
  
  METHODS
  Using data from a multicenter cohort study conducted in France, we performed a propensity-adjusted analysis to examine the association between the rate of relapse over a 2-year period and antipsychotic treatment (monotherapy vs. polypharmacy).
  
  
  RESULTS
  Our sample consisted in 183 patients; 50 patients (27.3%) had at least one period of relapse and 133 had no relapse (72.7%). Thirty-eight (37.7) percent of the patients received polypharmacy. The most severely ill patients were given polypharmacy: the age at onset of illness was lower in the polypharmacy group (p = 0.03). Patients that received polypharmacy also presented a higher general psychopathology PANSS subscore (p = 0.04) but no statistically significant difference was found in the PANSS total score or the PANSS positive or negative subscales. These patients were more likely to be given prescriptions for sedative drugs (p < 0.01) and antidepressant medications (p = 0.03). Relapse was found in 23.7% of patients given monotherapy and 33.3% given polypharmacy (p = 0.16). After stratification according to quintiles of the propensity score, which eliminated all significant differences for baseline characteristics, antipsychotic polypharmacy was not statistically associated with an increase of relapse: HR = 1.686 (0.812; 2.505).
  
  
  CONCLUSIONS
  After propensity score adjustment, antipsychotic polypharmacy is not statistically associated to an increase of relapse. Future randomised studies are needed to assess the impact of antipsychotic polypharmacy in schizophrenia.
authors.affiliation: Department of Public Health, EA 3279 Research Unit, University Hospital, Boulevard Jean Moulin 13385 Marseille, France.
authors.forename: Aurelie
authors.initials: A
authors.lastname: Millier
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Sarlon
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Azorin
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
authors.forename: Samuel
authors.initials: S
authors.lastname: Aballea
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.forename: Mondher
authors.initials: M
authors.lastname: Toumi
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000145:classification / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D057216:Propensity Score; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012008:Recurrence; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents