An Algorithm-Based Approach to First-Episode Schizophrenia: Response Rates Over 3 Prospective Antipsychotic Trials With a Retrospective Data Analysis

TY - JOUR

T1 - An Algorithm-Based Approach to First-Episode Schizophrenia: Response Rates Over 3 Prospective Antipsychotic Trials With a Retrospective Data Analysis

AU - Agid, Ofer

AU - Arenovich, Tamara

AU - Sajeev, Gautam

AU - Zipursky, Robert B.

AU - Kapur, Shitij

AU - Foussias, George

AU - Remington, Gary

PY - 2011/11

Y1 - 2011/11

N2 - Objective: Early, effective treatment in first-episode schizophrenia is advocated, although evidence based on a systematic approach over multiple antipsychotic trials is lacking. Employing a naturalistic design, we examined response rates over 3 circumscribed antipsychotic trials. Method: Between June 2003 and December 2008, 244 individuals with first-episode schizophrenia or schizoaffective disorder according to DSM-IV criteria were treated at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, following an algorithm that moved them through 2 antipsychotic trials, followed by a trial with clozapine. For the first 2 trials, treatment consisted of risperidone followed by olanzapine, or vice versa; each trial consisted of 3 stages (low-, full-, or high-dose) lasting up to 4 weeks at each level and adjusted according to response/tolerability. Clinical response was defined as a Clinical Global Impressions-Improvement score of 2 (much improved) or 1 (very much improved) and/or a Brief Psychiatric Rating Scale Thought Disorder subscale score

AB - Objective: Early, effective treatment in first-episode schizophrenia is advocated, although evidence based on a systematic approach over multiple antipsychotic trials is lacking. Employing a naturalistic design, we examined response rates over 3 circumscribed antipsychotic trials. Method: Between June 2003 and December 2008, 244 individuals with first-episode schizophrenia or schizoaffective disorder according to DSM-IV criteria were treated at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, following an algorithm that moved them through 2 antipsychotic trials, followed by a trial with clozapine. For the first 2 trials, treatment consisted of risperidone followed by olanzapine, or vice versa; each trial consisted of 3 stages (low-, full-, or high-dose) lasting up to 4 weeks at each level and adjusted according to response/tolerability. Clinical response was defined as a Clinical Global Impressions-Improvement score of 2 (much improved) or 1 (very much improved) and/or a Brief Psychiatric Rating Scale Thought Disorder subscale score

U2 - 10.4088/JCP.09m05785yel

DO - 10.4088/JCP.09m05785yel

M3 - Article

VL - 72

SP - 1439

EP - 1444

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

IS - 11

ER -