Stephen Z Levine1, Stefan Leucht. 1. Department of Community Mental Health, University of Haifa, Haifa, Israel. stezlev@gmail.com
Abstract
BACKGROUND: Differences between early- and delayed-responders to antipsychotic medication as a marker of subsequent symptom change to 18months are unknown. AIMS: To examine the association between initial non-, early- and delayed-response and subsequent symptom change up to 18months in the antipsychotic treatment of the symptoms of recent-episode schizophrenia. METHOD: Participants were from a double-blind randomized clinical trial of recent episode schizophrenia (n=263). Based on attainment of a 20% PANSS total change in the initial four weeks, the following groups were created and compared: "non-" (i.e., no-response): "early-" (i.e. within 2weeks) and "delayed-" (i.e. 3-4weeks) responders. Mixed modeling was used to predict PANSS percent change with group, time and the time-group interaction. RESULTS: Analysis of the PANSS total percent change showed significant (p<.01) group, time, and time-group interaction effects. Compared to non-responders, early-responders maintained significantly greater total response from week 5 to 44, and delayed-responders from week 5 to 20. After this time, non-responders and the other groups did not significantly differ on change. Generally, differences between the delayed- and early-responders were not statistically significance. Results were similar on the PANSS positive, negative and general psychopathology symptom subscales. CONCLUSIONS: Early-response is marked by up to 39weeks of longer subsequent symptom response than non-response, and infrequently differs to delayed-response. This has implications for consideration of switching and clinical trial design.
RCT Entities:
BACKGROUND: Differences between early- and delayed-responders to antipsychotic medication as a marker of subsequent symptom change to 18months are unknown. AIMS: To examine the association between initial non-, early- and delayed-response and subsequent symptom change up to 18months in the antipsychotic treatment of the symptoms of recent-episode schizophrenia. METHOD:Participants were from a double-blind randomized clinical trial of recent episode schizophrenia (n=263). Based on attainment of a 20% PANSS total change in the initial four weeks, the following groups were created and compared: "non-" (i.e., no-response): "early-" (i.e. within 2weeks) and "delayed-" (i.e. 3-4weeks) responders. Mixed modeling was used to predict PANSS percent change with group, time and the time-group interaction. RESULTS: Analysis of the PANSS total percent change showed significant (p<.01) group, time, and time-group interaction effects. Compared to non-responders, early-responders maintained significantly greater total response from week 5 to 44, and delayed-responders from week 5 to 20. After this time, non-responders and the other groups did not significantly differ on change. Generally, differences between the delayed- and early-responders were not statistically significance. Results were similar on the PANSS positive, negative and general psychopathology symptom subscales. CONCLUSIONS: Early-response is marked by up to 39weeks of longer subsequent symptom response than non-response, and infrequently differs to delayed-response. This has implications for consideration of switching and clinical trial design.
Authors: Dusan Hirjak; Peter Gass; Michael Deuschle; F Markus Leweke; Andreas Böhringer; Nadine Schenkel; Doris Borgwedel; Marco Heser; Antje Breisacher; Andreas Meyer-Lindenberg Journal: Nervenarzt Date: 2020-03 Impact factor: 1.214
Authors: E Sacchetti; C Magri; A Minelli; P Valsecchi; M Traversa; S Calza; A Vita; M Gennarelli Journal: Pharmacogenomics J Date: 2016-02-09 Impact factor: 3.550