What CATIE found

Results from the schizophrenia trial

Marvin S. Swartz, T. Scott Stroup, Joseph Patrick McEvoy, Sonia M. Davis, Robert A. Rosenheck, Richard S.E. Keefe, John K. Hsiao, Jeffrey A. Lieberman

Research output: Contribution to journalReview article

79 Citations (Scopus)

Abstract

The authors provide an overview of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) sponsored by the National Institute of Mental Health. CATIE was designed to compare a proxy first-generation antipsychotic, perphenazine, to several newer drugs. In phase 1 of the trial, consenting patients were randomly assigned to receive olanzapine, perphenazine, quetiapine, risperidone, or ziprasidone for up to 18 months on a double-blind basis. Patients with tardive dyskinesia were excluded from being randomly assigned to perphenazine and were assigned to one of the four second-generation antipsychotics in phase 1A. Clozapine was included in phase 2 of the study. Overall, olanzapine had the longest time to discontinuation in phase 1, but it was associated with significant weight and metabolic concerns. Perphenazine was not significantly different in overall effectiveness, compared with quetiapine, risperidone, and ziprasidone. Also, perphenazine was found to be the most cost-effective drug. Clozapine was confirmed as the most effective drug for individuals with a poor symptom response to previous antipsychotic drug trials, although clozapine was also associated with troublesome adverse effects. There were no differences in neurocognitive or psychosocial functioning in response to medications. Subsequent randomizations suggest that a poor response to an initial medication may mean that a different medication will be more effective or better tolerated. Although the CATIE results are controversial, they are broadly consistent with most previous antipsychotic drug trials and meta-analyses; however, the results may not generalize well to patients at high risk of tardive dyskinesia. Patient characteristics and clinical circumstances affected drug effectiveness; these patient factors are important in making treatment choices.

Original languageEnglish (US)
Pages (from-to)500-506
Number of pages7
JournalPsychiatric Services
Volume59
Issue number5
DOIs
StatePublished - May 1 2008

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Perphenazine
Antipsychotic Agents
Schizophrenia
Clinical Trials
olanzapine
Clozapine
Risperidone
Meta-Analysis
Pharmaceutical Preparations
National Institute of Mental Health (U.S.)
Drug Costs
Proxy
Random Allocation
Weights and Measures

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Swartz, M. S., Stroup, T. S., McEvoy, J. P., Davis, S. M., Rosenheck, R. A., Keefe, R. S. E., ... Lieberman, J. A. (2008). What CATIE found: Results from the schizophrenia trial. Psychiatric Services, 59(5), 500-506. https://doi.org/10.1176/appi.ps.59.5.500

What CATIE found : Results from the schizophrenia trial. / Swartz, Marvin S.; Stroup, T. Scott; McEvoy, Joseph Patrick; Davis, Sonia M.; Rosenheck, Robert A.; Keefe, Richard S.E.; Hsiao, John K.; Lieberman, Jeffrey A.

In: Psychiatric Services, Vol. 59, No. 5, 01.05.2008, p. 500-506.

Research output: Contribution to journalReview article

Swartz, MS, Stroup, TS, McEvoy, JP, Davis, SM, Rosenheck, RA, Keefe, RSE, Hsiao, JK & Lieberman, JA 2008, 'What CATIE found: Results from the schizophrenia trial', Psychiatric Services, vol. 59, no. 5, pp. 500-506. https://doi.org/10.1176/appi.ps.59.5.500
Swartz MS, Stroup TS, McEvoy JP, Davis SM, Rosenheck RA, Keefe RSE et al. What CATIE found: Results from the schizophrenia trial. Psychiatric Services. 2008 May 1;59(5):500-506. https://doi.org/10.1176/appi.ps.59.5.500
Swartz, Marvin S. ; Stroup, T. Scott ; McEvoy, Joseph Patrick ; Davis, Sonia M. ; Rosenheck, Robert A. ; Keefe, Richard S.E. ; Hsiao, John K. ; Lieberman, Jeffrey A. / What CATIE found : Results from the schizophrenia trial. In: Psychiatric Services. 2008 ; Vol. 59, No. 5. pp. 500-506.
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