Time to discontinuation of antipsychotic drugs in a schizophrenia cohort: influence of current treatment strategies. (December 2014)

• Record Type: Journal Article
• Authors: Kroken, Rune A.; Kjelby, Eirik; Wentzel-Larsen, Tore; Mellesdal, Liv S.; Jørgensen, Hugo A.; Johnsen, Erik
• Is Part Of: Therapeutic advances in psychopharmacology. Volume 4:Number 6(2014:Dec.)
• Page Start: 228
• Page End: 239
• Publication Date: 2014-12
• Subjects: schizophrenia -- antipsychotic -- clozapine -- treatment discontinuation -- long-acting injection antipsychotics (LAI); Psychopharmacology -- Periodicals; Psychotherapy -- Periodicals; 615.7805
• DOI: 10.1177/2045125314545614
• Languages: English
• ISSNs: 2045-1253

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.