Kroken Rune A, Kjelby Eirik, Wentzel-Larsen Tore, Mellesdal Liv S, Jørgensen Hugo A, Johnsen Erik
Division of Psychiatry, Haukeland University Hospital, Pb 23, 5812 Bergen, Norway.
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
Ther Adv Psychopharmacol. 2014 Dec;4(6):228-39. doi: 10.1177/2045125314545614.
Rates of discontinuation of antipsychotic treatment for patients with schizophrenia are high and evidence is limited by selective inclusion and high attrition in randomized controlled trials.
To study time to discontinuation of antipsychotic treatment for patients with schizophrenia.
All patients with schizophrenia (n = 396) discharged between 2005 and 2011 were followed until discontinuation (clinician or patient decided) of antipsychotic treatment or other endpoints. Univariate and multivariate survival analyses (with time on antipsychotic treatment as the dependent variable) using time-dependent variables were performed.
Clozapine displayed lower risk for all-cause (p < 0.001), clinician-decided (p = 0.012) and patient-decided (p = 0.039) discontinuation versus olanzapine oral treatment in the multivariate Cox regression. Second-generation long-acting injection antipsychotics (LAI) (p = 0.015) and first-generation long-acting injection antipsychotics (p = 0.013) showed significantly lower risks for patient-decided discontinuation than olanzapine oral.
Higher effectiveness of clozapine and LAI treatment versus oral olanzapine were identified in a clinical cohort of patients with schizophrenia.
精神分裂症患者抗精神病药物治疗的停药率很高，且随机对照试验中的选择性纳入和高损耗率限制了相关证据。
研究精神分裂症患者抗精神病药物治疗的停药时间。
对2005年至2011年间出院的所有精神分裂症患者（n = 396）进行随访，直至抗精神病药物治疗停药（由临床医生或患者决定）或出现其他终点事件。使用时间依赖性变量进行单变量和多变量生存分析（以抗精神病药物治疗时间为因变量）。
在多变量Cox回归中，与奥氮平口服治疗相比，氯氮平在全因停药（p < 0.001）、临床医生决定停药（p = 0.012）和患者决定停药（p = 0.039）方面的风险较低。第二代长效注射用抗精神病药物（p = 0.015）和第一代长效注射用抗精神病药物（p = 0.013）在患者决定停药方面的风险显著低于奥氮平口服制剂。
在一组精神分裂症临床患者中，发现氯氮平和长效注射用抗精神病药物治疗比奥氮平口服制剂更有效。
