Rune A Kroken1, Eirik Kjelby2, Tore Wentzel-Larsen3, Liv S Mellesdal2, Hugo A Jørgensen4, Erik Johnsen5. 1. Division of Psychiatry, Haukeland University Hospital, Pb 23, 5812 Bergen, Norway. 2. Division of Psychiatry, Haukeland University Hospital, Bergen, Norway. 3. Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway. 4. Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Norway. 5. Division of Psychiatry, Haukeland University Hospital, Bergen, Norway Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Norway.
Abstract
BACKGROUND: Rates of discontinuation of antipsychotic treatment for patients with schizophrenia are high and evidence is limited by selective inclusion and high attrition in randomized controlled trials. AIMS: To study time to discontinuation of antipsychotic treatment for patients with schizophrenia. METHOD: All patients with schizophrenia (n = 396) discharged between 2005 and 2011 were followed until discontinuation (clinician or patient decided) of antipsychotic treatment or other endpoints. Univariate and multivariate survival analyses (with time on antipsychotic treatment as the dependent variable) using time-dependent variables were performed. RESULTS: Clozapine displayed lower risk for all-cause (p < 0.001), clinician-decided (p = 0.012) and patient-decided (p = 0.039) discontinuation versus olanzapine oral treatment in the multivariate Cox regression. Second-generation long-acting injection antipsychotics (LAI) (p = 0.015) and first-generation long-acting injection antipsychotics (p = 0.013) showed significantly lower risks for patient-decided discontinuation than olanzapine oral. CONCLUSION: Higher effectiveness of clozapine and LAI treatment versus oral olanzapine were identified in a clinical cohort of patients with schizophrenia.
BACKGROUND: Rates of discontinuation of antipsychotic treatment for patients with schizophrenia are high and evidence is limited by selective inclusion and high attrition in randomized controlled trials. AIMS: To study time to discontinuation of antipsychotic treatment for patients with schizophrenia. METHOD: All patients with schizophrenia (n = 396) discharged between 2005 and 2011 were followed until discontinuation (clinician or patient decided) of antipsychotic treatment or other endpoints. Univariate and multivariate survival analyses (with time on antipsychotic treatment as the dependent variable) using time-dependent variables were performed. RESULTS:Clozapine displayed lower risk for all-cause (p < 0.001), clinician-decided (p = 0.012) and patient-decided (p = 0.039) discontinuation versus olanzapine oral treatment in the multivariate Cox regression. Second-generation long-acting injection antipsychotics (LAI) (p = 0.015) and first-generation long-acting injection antipsychotics (p = 0.013) showed significantly lower risks for patient-decided discontinuation than olanzapine oral. CONCLUSION: Higher effectiveness of clozapine and LAI treatment versus oral olanzapine were identified in a clinical cohort of patients with schizophrenia.
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