Comparing Antipsychotic Treatments for Schizophren

Authors: Lewei Allison Lin Robert Rosenheck Catherine Sugar Arthur Zbrozek

Publish Date: 2014/10/08

Volume: 86, Issue: 1, Pages: 107-121

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Abstract

The overall impact of first and second generation antipsychotics on quality of life and symptoms of people with schizophrenia remains controversial We applied health state modeling to data from the Clinical Antipsychotic Trials of Intervention Effectiveness CATIE Schizophrenia study a randomized trial of antipsychotic medications and evaluated the likelihood of patients moving to more favorable health states over time We applied Kmeans clustering to the data to create discrete groupings of patients with symptom and side effect characteristics that were then validated using quality of life measures We compared cluster distributions across medications at baseline and 6 months after randomization 1049 patients were included in the initial cluster analysis Five health states were identified 1 low symptoms and low side effects LS + LSE 2 low symptoms and obesity LS + Ob 3 high symptoms and low side effects HS + LSE 4 high symptoms with depression and akathisia HS + Dp + Ak and 5 moderate symptoms and high side effects MS + HSE Sixmonth outcomes among patients randomly assigned to perphenazine olanzapine risperidone and quetiapine were compared At baseline almost 20  of patients were in the worst health state HS + Dp + Ak with greater decreases at 6 months in this health state for perphenazine 92  decrease and olanzapine 111  groups compared to risperidone 47  and quetiapine 67  This study demonstrated that health state analysis can provide insight into the overall clinical state of patients beyond the mere comparison of average scores and largely confirmed original CATIE findingsCatherine Sugar and Lewei Allison Lin declare that they have no conflict of interest Arthur Zbrozek was employed by Wyeth Pharmaceuticals at the time of this study Robert Rosenheck received partial support for the analyses presented in this paper from Wyeth Pharmaceuticals currently Pfizer All authors contributed to and have approved the final manuscriptAll procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation institutional and national and with the Helsinki Declaration of 1975 as revised in 2000 Informed consent was obtained from all patients for being included in the study

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