TY - JOUR
T1 - Does switching to a new antipsychotic improve outcomes?. Data from the CATIE Trial
AU - Rosenheck, Robert A.
AU - Davis, Sonia
AU - Covell, Nancy
AU - Essock, Susan
AU - Swartz, Marvin
AU - Stroup, Scott
AU - McEvoy, Joseph Patrick
AU - Lieberman, Jeffrey
N1 - Funding Information:
Dr. Davis is an employee of Quintiles and reports having received consulting fees from Eli Lilly and Pfizer. Dr. Lieberman reports having received research funding from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb, GlaxoSmithKline, Janssen Pharmaceutica Products, and Pfizer Inc.; and consulting and educational fees from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb, Eli Lilly and Co., Forest Pharmaceutical Company, GlaxoSmithKline, Janssen Pharmaceutica Products, Novartis, Pfizer Inc., and Solvay. Dr. Stroup reports having received research funding from Eli Lilly and Co.; and consulting fees from Janssen Pharmaceutica Products, GlaxoSmithKline, and Bristol-Myers Squibb. Dr. McEvoy reports having received research funding from AstraZeneca, Forest Research Institute, Eli Lilly and Co., Janssen Pharmaeutica, and Pfizer Inc.; consulting or advisory board fees from Pfizer Inc. and Bristol-Myers Squibb; and lecture fees from Janssen Pharmaceutica, and Bristol-Myers Squibb. Dr. Swartz reports having received research funding from Eli Lilly and Co., and consulting and educational fees from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb, Eli Lilly and Co., and Pfizer Inc.
Funding Information:
The CATIE study was funded by the NIMH. I had control of all the data involved in this analysis and NIMH had no input into the paper.
PY - 2009/1
Y1 - 2009/1
N2 - Purpose: Previous analysis of data from CATIE showed that patients randomly assigned to switch to a new medication were more likely to discontinue study drug than those who stayed on the medication they had been taking prior to randomization. This study addresses additional outcomes measures evaluating symptoms, neurocognition, quality of life, neurological side effects, weight, and health costs. First, considering patients randomized to olanzapine or risperidone, outcomes among patients who had been on the drug to which they were randomized prior to CATIE (N = 129 "stayers") were compared to outcomes of those who switched to either of these two drugs (N = 269 "switchers"). A second set of analyses considered patients on baseline monotherapy with olanzapine (N = 297); risperidone (N = 252) or quetiapine (n = 87) and compared those randomly assigned to stay on each of these medications with those assigned to switch to any of the other five phase 1 medications in CATIE. In mixed models of each outcome the independent variable of primary interest represented stay vs. switch, with multivariate adjustment for potential confounding factors. Results: With one exception, there were no significant differences between stayers and switchers on any outcome measure in either set of analyses. The exception was that, in the second set of analyses, patients who stayed on olanzapine showed greater weight gain than those who switched from olanzapine to other drugs. Conclusion: Switching to a new medication yielded no advantage over staying on the previous medication. Staying on olanzapine was associated with greater weight gain.
AB - Purpose: Previous analysis of data from CATIE showed that patients randomly assigned to switch to a new medication were more likely to discontinue study drug than those who stayed on the medication they had been taking prior to randomization. This study addresses additional outcomes measures evaluating symptoms, neurocognition, quality of life, neurological side effects, weight, and health costs. First, considering patients randomized to olanzapine or risperidone, outcomes among patients who had been on the drug to which they were randomized prior to CATIE (N = 129 "stayers") were compared to outcomes of those who switched to either of these two drugs (N = 269 "switchers"). A second set of analyses considered patients on baseline monotherapy with olanzapine (N = 297); risperidone (N = 252) or quetiapine (n = 87) and compared those randomly assigned to stay on each of these medications with those assigned to switch to any of the other five phase 1 medications in CATIE. In mixed models of each outcome the independent variable of primary interest represented stay vs. switch, with multivariate adjustment for potential confounding factors. Results: With one exception, there were no significant differences between stayers and switchers on any outcome measure in either set of analyses. The exception was that, in the second set of analyses, patients who stayed on olanzapine showed greater weight gain than those who switched from olanzapine to other drugs. Conclusion: Switching to a new medication yielded no advantage over staying on the previous medication. Staying on olanzapine was associated with greater weight gain.
KW - Antipsychotic medications
KW - Quality of life
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=58149129309&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58149129309&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2008.09.031
DO - 10.1016/j.schres.2008.09.031
M3 - Article
C2 - 18993031
AN - SCOPUS:58149129309
SN - 0920-9964
VL - 107
SP - 22
EP - 29
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1
ER -