Abstract
BackgroundTo identify patient characteristics and early changes in patients' clinical status that best predict subsequent switching of antipsychotic agents in the long-term treatment of schizophrenia.MethodsThis post-hoc analysis used data from a one-year randomized, open-label, multisite study of antipsychotics in the treatment of schizophrenia. The study protocol permitted switching of antipsychotics when clinically warranted after the first eight weeks. Baseline patient characteristics were assessed using standard psychiatric measures and reviews of medical records. The prediction model included baseline sociodemographics, comorbid psychiatric and non-psychiatric conditions, body weight, clinical and functional variables, as well as change scores on standard efficacy and tolerability measures during the first two weeks of treatment. Cox proportional hazards modeling was used to identify the best predictors of switching from the initially assigned antipsychotic medication.ResultsAbout one-third of patients (29.5%, 191/648) switched antipsychotics before the end of the one-year study. There were six variables identified as the best predictors of switching: lack of antipsychotic use in the prior year, pre-existing depression, female gender, lack of substance use disorder, worsening of akathisia (as measured by the Barnes Akathisia Scale), and worsening of symptoms of depression/anxiety (subscale score on the Positive and Negative Syndrome Scale) during the first two weeks of antipsychotic therapy.ConclusionsSwitching antipsychotics appears to be prevalent in the naturalistic treatment of schizophrenia and can be predicted by a small and distinct set of variables. Interestingly, worsening of anxiety and depressive symptoms and of akathisia following two weeks of treatment were among the more robust predictors of subsequent switching of antipsychotics.
Highlights
To identify patient characteristics and early changes in patients’ clinical status that best predict subsequent switching of antipsychotic agents in the long-term treatment of schizophrenia
A change in the antipsychotic medication regimen is warranted, representing a rational rescue treatment option in the hope that the switch will result in better treatment outcomes for the patient [3,4,5,6,7,8,9,10]
The purpose of our study was to expand current research and identify individual patient characteristics that best predict switching of antipsychotic medications among predominately outpatients treated for schizophrenia and related disorders
Summary
To identify patient characteristics and early changes in patients’ clinical status that best predict subsequent switching of antipsychotic agents in the long-term treatment of schizophrenia. Generally effective in ameliorating core manifestations of the disease, some patients experience only suboptimal responses or are intolerant of the medication This may include insufficient improvement or even worsening of symptoms, as well as a variety of treatment-related adverse events [1,2]. Under such clinical circumstances, a change (i.e., switch) in the antipsychotic medication regimen is warranted, representing a rational rescue treatment option in the hope that the switch will result in better treatment outcomes for the patient [3,4,5,6,7,8,9,10]. The study concluded that high levels of outpatient and inpatient service use were the most powerful predictors of switching, while sociodemographic, institutional, diagnostic, and functional measures were predictive in some cases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
