title: One-year, randomized, open trial comparing olanzapine, quetiapine, risperidone and ziprasidone effectiveness in antipsychotic-naive patients with a first-episode psychosis.
abstract: The aim of this study was to compare the 12-month effectiveness of several second-generation antipsychotic drugs, with that of haloperidol in never-treated patients with first-episode psychosis. In total, 114 patients without life time exposure to any psychotropic medication were randomized to haloperidol, olanzapine, risperidone, quetiapine or ziprasidone. Primary outcome was time to all-cause discontinuation. Secondary outcomes included discontinuation rates and symptom change as measured by the Positive and Negative Syndrome Scale (PANSS). The overall discontinuation rate 64%. At 12 months, the proportion of patients discontinuing treatment was 40.0% for olanzapine, 56.5% for quetiapine, 64.0% for risperidone, 80.0% for ziprasidone and 85.7% for haloperidol. Mean time to antipsychotic discontinuation was higher in patients randomized to second-generation antipsychotics than in those taking haloperidol. Significantly lower discontinuation was noted in patients on olanzapine than on haloperidol, or ziprasidone. Our results suggest that olanzapine might lead to longer treatment continuation in treatment naïve FEP patients than haloperidol and, possibly ziprasidone. Global psychopathology was significantly less reduced by haloperidol than with each individual SGA in this earliest phase of treatment.
authors.affiliation: Department of Child and Adolescent Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, ES 08950 Esplugues de Llobregat, Barcelona, Spain. 12636lsm@comb.cat
authors.forename: Luis
authors.initials: L
authors.lastname: San
authors.forename: Belen
authors.initials: B
authors.lastname: Arranz
authors.forename: Victor
authors.initials: V
authors.lastname: Perez
authors.forename: Gemma
authors.initials: G
authors.lastname: Safont
authors.forename: Iluminada
authors.initials: I
authors.lastname: Corripio
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ramirez
authors.forename: Rosa
authors.initials: R
authors.lastname: Dueñas
authors.forename: Enric
authors.initials: E
authors.lastname: Alvarez
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010879:Piperazines / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000188:drug therapy*; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy; D013844:Thiazoles / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010879:Piperazines; D013844:Thiazoles; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; C092292:ziprasidone; D018967:Risperidone; D000077152:Olanzapine