Discontinuation of treatment of schizophrenic patients is driven by poor symptom response: a pooled post-hoc analysis of four atypical antipsychotic drugsReport as inadecuate




Discontinuation of treatment of schizophrenic patients is driven by poor symptom response: a pooled post-hoc analysis of four atypical antipsychotic drugs - Download this document for free, or read online. Document in PDF available to download.

BMC Medicine

, 3:21

First Online: 23 December 2005Received: 19 July 2005Accepted: 23 December 2005DOI: 10.1186-1741-7015-3-21

Cite this article as: Liu-Seifert, H., Adams, D.H. & Kinon, B.J. BMC Med 2005 3: 21. doi:10.1186-1741-7015-3-21

Abstract

BackgroundStopping antipsychotic treatment can interrupt improvement and exacerbate the illness. The reasons for discontinuing treatment during controlled clinical trials were analyzed to explore this phenomenon.

MethodsA post-hoc, pooled analysis was made of 4 randomized, double-blind clinical trials, 24–28 weeks in duration, involving 1627 patients with schizophrenia or a related disorder. Analyses combined all the atypical antipsychotic treatment groups in the studies.

ResultsThe majority of patients 53% stopped their treatment at an early stage. Poor psychiatric response along with worsening symptoms was the most frequently given reason for discontinuing the course 36%, which was substantially more common than discontinuation due to poor tolerability of the medication 12%. This phenomenon was corroborated by less improvement in patients who discontinued treatment compared with those who completed, based on the PANSS total scores. Discontinuation due to poor response was, apparently, more predominantly linked to patient perception than to physicians- conclusions alone 80% vs. 20%. Discontinuation due to patient perception of poor response appeared to occur particularly early in the course of treatment. Patients who discontinued due to poor toleration of the medication responded in a more comparable manner with completers.

ConclusionDiscontinuing treatment may lead to exacerbation of symptoms, undermining therapeutic progress. In these studies, poor response to treatment and worsening of underlying psychiatric symptoms, and to a lesser extent, intolerability to medication were the primary contributors to treatment being discontinued. Our findings suggest that adherence may be enhanced by effective symptom control, as objectively measured and as subjectively perceived. Such strategies may improve patients- willingness to undertake long-term therapy and increase the likelihood of a better prognosis.

Electronic supplementary materialThe online version of this article doi:10.1186-1741-7015-3-21 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Author: Hong Liu-Seifert - David H Adams - Bruce J Kinon

Source: https://link.springer.com/







Related documents