Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine: A CATIE study

T. Scott Stroup, Jeffrey A. Lieberman, Joseph Patrick McEvoy, Marvin S. Swartz, Sonia M. Davis, George A. Capuano, Robert A. Rosenheck, Richard S.E. Keefe, Alexander L. Miller, Irving Belz, John K. Hsiao

Research output: Contribution to journalArticle

131 Citations (Scopus)

Abstract

Objective: The relative effectiveness of newly started antipsychotic drugs for individuals with schizophrenia may depend on multiple factors, including each patient's previous treatment response and the reason for a new medication trial. This randomized, double-blind study compared olanzapine, quetiapine, and risperidone in patients who had just discontinued the older antipsychotic perphenazine. Method: Subjects with schizophrenia (N= 114) who had been randomly assigned to and then discontinued perphenazine in phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study were reassigned randomly to double-blinded treatment with olanzapine, 7.5-30.0 mg/day (N=38); quetiapine, 200-800 mg/day (N=38); or risperidone, 1.5-6.0 mg/day (N=38). The primary aim was to determine whether there were differences among these three treatments in effectiveness, as measured by time to treatment discontinuation for any reason. Secondary outcomes included reasons for treatment discontinuation and measures of drug tolerability. Results: The time to treatment discontinuation was longer for patients treated with quetiapine (median, 9.9 months) and olanzapine (7.1 months) than with risperidone (3.6 months). There were no significant differences between treatments on discontinuation due to inefficacy, intolerability, or patient decision. Conclusions: Among this group of patients with chronic schizophrenia who had just discontinued the older antipsychotic perphenazine, quetiapine and olanzapine were more effective than risperidone, as reflected by longer time to discontinuation for any reason. In the context of other results from the CATIE study, the effectiveness and acceptability of antipsychotic drugs appears to vary considerably according to clinical circumstances.

Original languageEnglish (US)
Pages (from-to)415-427
Number of pages13
JournalAmerican Journal of Psychiatry
Volume164
Issue number3
DOIs
StatePublished - Jan 1 2007

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olanzapine
Perphenazine
Risperidone
Antipsychotic Agents
Schizophrenia
Clinical Trials
Therapeutics
Clinical Trials, Phase I
Double-Blind Method
Quetiapine Fumarate

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine : A CATIE study. / Stroup, T. Scott; Lieberman, Jeffrey A.; McEvoy, Joseph Patrick; Swartz, Marvin S.; Davis, Sonia M.; Capuano, George A.; Rosenheck, Robert A.; Keefe, Richard S.E.; Miller, Alexander L.; Belz, Irving; Hsiao, John K.

In: American Journal of Psychiatry, Vol. 164, No. 3, 01.01.2007, p. 415-427.

Research output: Contribution to journalArticle

Stroup, TS, Lieberman, JA, McEvoy, JP, Swartz, MS, Davis, SM, Capuano, GA, Rosenheck, RA, Keefe, RSE, Miller, AL, Belz, I & Hsiao, JK 2007, 'Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine: A CATIE study', American Journal of Psychiatry, vol. 164, no. 3, pp. 415-427. https://doi.org/10.1176/ajp.2007.164.3.415
Stroup, T. Scott ; Lieberman, Jeffrey A. ; McEvoy, Joseph Patrick ; Swartz, Marvin S. ; Davis, Sonia M. ; Capuano, George A. ; Rosenheck, Robert A. ; Keefe, Richard S.E. ; Miller, Alexander L. ; Belz, Irving ; Hsiao, John K. / Effectiveness of olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia after discontinuing perphenazine : A CATIE study. In: American Journal of Psychiatry. 2007 ; Vol. 164, No. 3. pp. 415-427.
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abstract = "Objective: The relative effectiveness of newly started antipsychotic drugs for individuals with schizophrenia may depend on multiple factors, including each patient's previous treatment response and the reason for a new medication trial. This randomized, double-blind study compared olanzapine, quetiapine, and risperidone in patients who had just discontinued the older antipsychotic perphenazine. Method: Subjects with schizophrenia (N= 114) who had been randomly assigned to and then discontinued perphenazine in phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study were reassigned randomly to double-blinded treatment with olanzapine, 7.5-30.0 mg/day (N=38); quetiapine, 200-800 mg/day (N=38); or risperidone, 1.5-6.0 mg/day (N=38). The primary aim was to determine whether there were differences among these three treatments in effectiveness, as measured by time to treatment discontinuation for any reason. Secondary outcomes included reasons for treatment discontinuation and measures of drug tolerability. Results: The time to treatment discontinuation was longer for patients treated with quetiapine (median, 9.9 months) and olanzapine (7.1 months) than with risperidone (3.6 months). There were no significant differences between treatments on discontinuation due to inefficacy, intolerability, or patient decision. Conclusions: Among this group of patients with chronic schizophrenia who had just discontinued the older antipsychotic perphenazine, quetiapine and olanzapine were more effective than risperidone, as reflected by longer time to discontinuation for any reason. In the context of other results from the CATIE study, the effectiveness and acceptability of antipsychotic drugs appears to vary considerably according to clinical circumstances.",
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AU - Swartz, Marvin S.

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AU - Capuano, George A.

AU - Rosenheck, Robert A.

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N2 - Objective: The relative effectiveness of newly started antipsychotic drugs for individuals with schizophrenia may depend on multiple factors, including each patient's previous treatment response and the reason for a new medication trial. This randomized, double-blind study compared olanzapine, quetiapine, and risperidone in patients who had just discontinued the older antipsychotic perphenazine. Method: Subjects with schizophrenia (N= 114) who had been randomly assigned to and then discontinued perphenazine in phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study were reassigned randomly to double-blinded treatment with olanzapine, 7.5-30.0 mg/day (N=38); quetiapine, 200-800 mg/day (N=38); or risperidone, 1.5-6.0 mg/day (N=38). The primary aim was to determine whether there were differences among these three treatments in effectiveness, as measured by time to treatment discontinuation for any reason. Secondary outcomes included reasons for treatment discontinuation and measures of drug tolerability. Results: The time to treatment discontinuation was longer for patients treated with quetiapine (median, 9.9 months) and olanzapine (7.1 months) than with risperidone (3.6 months). There were no significant differences between treatments on discontinuation due to inefficacy, intolerability, or patient decision. Conclusions: Among this group of patients with chronic schizophrenia who had just discontinued the older antipsychotic perphenazine, quetiapine and olanzapine were more effective than risperidone, as reflected by longer time to discontinuation for any reason. In the context of other results from the CATIE study, the effectiveness and acceptability of antipsychotic drugs appears to vary considerably according to clinical circumstances.

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