Disorders - Psychosis Disorders
Findling, Robert L., Kafantaris, Vivian, Pavuluri, Mani, McNamara, Nora K., McClellan, Jon, Frazier, Jean A., Sikich, Linmarie, Kowatch, Robert, Lingler, Jacqui, Faber, Jon, Rowles, Brieana M., Clemons, Traci E., Taylor-Zapata, Perdita
Objective: The primary goal of this exploratory study was to obtain data that could lead to evidence-based dosing strategies for lithium in children and adolescents suffering from bipolar I disorder. Methods: Outpatients aged 7 - 17 years meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition, diagnostic criteria for bipolar I disorder (manic or mixed) were eligible for 8 weeks of open label treatment with lithium in one of three dosing arms. In Arm I, participants began treatment at a dose of 300 mg of lithium twice daily. The starting dose of lithium in Arms II and III was 300 mg thrice daily. Patients in Arms I and II could have their dose increased by 300 mg/day, depending on clinical response, at weekly visits. Patients in Arm III also had mid-week telephone interviews after which they could also have their dose of lithium increased by 300 mg per day. Youths weighing <30 kg were automatically assigned to ArmI, whereas youths weighing ≥30 kg were randomly assigned to ArmI, II, or III. Randomization was balanced by age (7 - 11 years, 12 - 17 years) and sex in approximately equal numbers. A priori response criteria were defined as a Clinical Global Impressions-Improvement scale score of ≤2 and a 50% decrease from baseline on the Young Mania Rating Scale. Results: Of the 61 youths [32 males (52.5%)] who received open-label lithium, 60 youths completed at least 1 week of treatment and returned for a postbaseline assessment. Most patients had a ≥50% improvement in Young Mania Rating Scale score, and more than half of the patients (58%) achieved response. Overall, lithium was well tolerated. All three treatment arms had similar effectiveness, side effect profiles, and tolerability of lithium. Conclusions: On the basis of these results, a dosing strategy in which pediatric patients begin lithium at a dose of 300 mg thrice daily (with an additional 300 mg increase during the first week), followed by 300 mg weekly increases until a priori stopping criteria are met, will be used in an upcoming randomized, placebo-controlled trial. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Journal of Child & Adolescent Psychopharmacology, 21(3) : 195-205
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Anticonvulsants/mood stabilisers (excl. lithium), Lithium, Service Delivery & Improvement, Other service delivery and improvement interventions
Crespo-Facorro, Benedicto, Perez-Iglesias, R, Mata, Ignacio, Caseiro, Olalla, Martinez-Garcia, Obdulia, Pardo, Gema, Ramirez-Bonilla, MariLuz, Pelayo-Teran, Jose Maria, Vazquez-Barquero, Jose L.
The effectiveness of antipsychotics in preventing relapses and attaining symptomatic remission is a relevant topic of psychopharmacological research. The purpose of the present study was to compare the relapse and symptomatic remission rates during the first year of treatment between low doses of haloperidol and SGAs (olanzapine and risperidone) in drug-naïve first-episode non-affective psychosis individuals. This is a prospective, randomized, open-label study conducted from February 2001 to February 2006. Data for the present investigation were obtained from a large epidemiologic and 3-year longitudinal intervention program of first-episode psychosis (DSM-IV criteria) conducted at the University Hospital Marques de Valdecilla, Santander, Spain. One hundred and seventy four patients were randomly assigned to haloperidol (N = 56), olanzapine (N = 55), or risperidone (N = 63) and followed up for 1 year. Primary effectiveness measures were the time up to relapse and rates of relapse and symptomatic remission. There were no significant differences in the relapse rate between treatments (11.1% haloperidol; 18.5% olanzapine, and 13.8% risperidone) (χ 2 = 1.230; p = 0.541) or in the time up to relapse (Log Rank χ 2 = 0.308; p = 0.857). The rates of relapse for adherent (11.2%) and non-adherent (26.9%) patients were significantly different (χ 2 = 4.215; df = 1; p = 0.040). The remission rate did not differ significantly between treatment groups (χ 2 = 2.760; p = 0.252) and adherence to medication did not seem to significantly influence remission rates. We conclude that haloperidol, olanzapine and risperidone show a similar effectiveness in relapse prevention or in remission attainment during the first year of treatment. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Psychiatric Research, 45(6) : 763-769
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
, Relapse prevention
-
Treatment and intervention: Biological Interventions (any)
, Typical Antipsychotics (first generation)
, Atypical Antipsychotics (second generation)
Crespo-Facorro, Benedicto, Perez-Iglesias, R, Mata, Ignacio, Ramirez-Bonilla, MariLuz, Martinez-Garcia, Obdulia, Pardo-Garcia, Gema, Caseiro, Olalla, Pelayo-Teran, Jose Maria, Vazquez-Barquero, Jose L.
The aim of this study was to investigate the long-term effectiveness and efficacy of haloperidol, risperidone and olanzapine in first-episode schizophrenia-spectrum disorders. This was a prospective, randomized, open-label study. Data for the present investigation were obtained from a large epidemiological and 3-year longitudinal intervention programme of first-episode psychosis conducted at the University Hospital Marques de Valdecilla, Santander, Spain. One hundred and seventy-four patients were randomly assigned to haloperidol (N = 56), olanzapine (N = 55), or risperidone (N = 63) and followed up for 1 year. The primary effectiveness measure was all causes of treatment discontinuation. Effectiveness analyses were based on intend-to-treat populations. In addition, an analysis based on per protocol populations was conducted in the analysis for clinical efficacy. The treatment discontinuation rate for any cause was higher with haloperidol than with risperidone and olanzapine (χ² = 8.517; p = 0.014). The difference in discontinuation rate between risperidone and olanzapine was not significant (χ² = 0.063; p = 0.802). There were no significant advantages of any of the three treatments in reducing the severity of psychopathology. Risperidone and olanzapine demonstrated higher effectiveness relative to haloperidol, but the three antipsychotics were equally effective in reducing the severity of psychopathology. Specific clinical programmes and the use of second-generation antipsychotics may enhance the effectiveness of antipsychotic treatments. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Psychopharmacology, 25(6) : 744-754
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Biological Interventions (any)
, Typical Antipsychotics (first generation)
, Atypical Antipsychotics (second generation)
Dean, A. J., Bellgrove, M. A., Hall, T., Phan, W. M., Eyles, D. W., Kvaskoff, D., McGrath, J. J.
Epidemiological research links vitamin D status to various brain-related outcomes. However, few trials examine whether supplementation can improve such outcomes and none have examined effects on cognition. This study examined whether Vitamin D supplementation led to improvements in diverse measures of cognitive and emotional functioning, and hypothesised that supplementation would lead to improvements in these outcomes compared to placebo. Healthy young adults were recruited to a parallel-arm, double-blind trial conducted at The University of Queensland. Participants were randomly allocated to receive Vitamin D (one capsule daily, containing 5000 IU cholecalciferol) or identical placebo capsule for six weeks. All participants and outcome assessors were blinded to group assignment. Primary outcome measures assessed at baseline and 6 weeks were working memory, response inhibition and cognitive flexibility. Secondary outcomes were: hallucination-proneness, psychotic-like experiences, and ratings of depression, anxiety and anger. 128 participants were recruited, randomised and included in primary analyses (vitamin D n = 63; placebo n = 65). Despite significant increases in vitamin D status in the active group, no significant changes were observed in working memory (F = 1.09; p = 0.30), response inhibition (F = 0.82; p = 0.37), cognitive flexibility (F = 1.37; p = 0.24) or secondary outcomes. No serious adverse effects were reported. Our findings indicate that vitamin D supplementation does not influence cognitive or emotional functioning in healthy young adults. Future controlled trials in targeted populations of interest are required to determine whether supplementation can improve functioning in these domains. Australian and New Zealand Clinical Trials Registry; ACTRN12610000318088.
PLoS ONE, 6(11) : e25966
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Vitamins and supplements
Eack, Shaun M., Hogarty, Gerard E., Greenwald, Deborah P., Hogarty, Susan S., Keshavan, Matcheri S.
Objective: To examine the effects of psychosocial cognitive rehabilitation on employment outcomes in a randomized controlled trial for individuals with early course schizophrenia. Method: Early course schizophrenia outpatients (N = 58) were randomly assigned to cognitive enhancement therapy (CET) or an enriched supportive therapy (EST) control and treated for 2 years. Comprehensive data on cognition and employment were collected annually. Results: Individuals treated with CET were significantly more likely to be competitively employed, had greater earnings from employment, and were more satisfied with their employment status by the end of treatment compared to EST recipients. Mediator analyses revealed that improvements in both social and nonsocial cognition mediated CET effects on employment. Conclusion: CET can help facilitate employment in early schizophrenia by addressing the cognitive impairments that limit functioning in the disorder. Inclusion of cognitive rehabilitation in social work practice can support more optimal functional recovery from schizophrenia. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Research on Social Work Practice, 21(1) : 32-42
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive remediation therapy, Supportive therapy
Kane, J. M., Hochfeld, M., Meng, X.
Background: Iloperidone (ILO), a mixed D2/5-HT2 antagonist, is indicated for the treatment of schizophrenia. This analysis evaluated the treatment effects of ILO in patients with early-stage schizophrenia in short-term trials. Methods: Data were pooled from 4 double-blind, placebo (PBO)-controlled trials (4 or 6 weeks' duration) that enrolled adult patients with schizophrenia/schizoaffective disorder (schizoaffective patients were excluded from this analysis). This analysis compared efficacy in patients with early stage ((less-than or equal to)25 years of age or (less-than or equal to)5 years since onset at baseline) vs. non-early stage schizophrenia. Brief Psychiatric Rating Scale-derived (BPRSd) and Positive and Negative Syndrome Scale Total (PANSS-T) scores were analyzed. To calculate reductions from baseline, the last observation before Week 4 (1 study) or 6 (3 studies) was carried forward until Week 4 or 6, respectively, in the intent-to-treat population. To compare reductions between treatments, least squared mean (LSM) change (plus or minus) standard error (SE) was derived from an analysis of covariance model with treatment, study, early stage, and treatment by early stage as factors; baseline as a covariate. Results: 1498 Patients were included in this analysis (410 with early stage and 1088 with non-early stage schizophrenia). At Week 4/ Week 6, LSM (plus or minus) SE mean changes (null = P < .05 vs. PBO) in PANSS-T scores among early patients were -8.0 (plus or minus) 2.2/-8.9 (plus or minus) 2.3 with ILO 4-8 mg/day, -13.4 (plus or minus) 1.9null/-14.0 (plus or minus) 2.1null with ILO 10-16 mg/day, -12.2 (plus or minus) 1.9/-18.0 (plus or minus) 3.2null with ILO 20-24 mg/day, and -7.4 (plus or minus) 1.8/-5.3 (plus or minus) 2.3 with PBO. Significant reductions vs. PBO were observed in BPRSd (ILO 10-16 mg/day at Weeks 4 and 6, and ILO 20-24 mg/day at Week 6). Corresponding changes in PANSS-T among non-early stage patients were -7.5 (plus or minus) 1.5/-7.8 (plus or minus) 1.6, -9.6 (plus or minus) 1.2null/-9.7 (plus or minus) 1.3null,-9.8 (plus or minus) 1.4null/-9.4 (plus or minus) 2.8, and-5.0 (plus or minus) 1.0/-5.8 (plus or minus) 1.4, respectively. Significant reductions vs. PBO in non-early stage patients were also observed in BPRSd (ILO 10-16 mg/day at Weeks 4 and 6, and ILO 20- 24 mg/day at Week 4). Early stage patients responded numerically better than non-early stage patients, with significance seen with ILO 20-24 mg/day at Week 6 (PANSS-T and BPRSd, P < .05). Conclusion: These results suggest that ILO is effective for symptom improvement in schizophrenia patients regardless of duration of illness, and that patients with early stage schizophrenia respond well. Early stage patients responded numerically better than non-early stage patients, with significance seen with ILO 20-24 mg/day at Week 6. Support: Novartis Pharmaceuticals Corporation.
Schizophrenia Bulletin, 37 : 308
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Atypical Antipsychotics (second generation)
Gentile, S.
The onset of severe, chronic or recurrent psychiatric illnesses, such as schizophrenia-spectrum and bipolar disorders, is a dramatic clinical event often detectable during adolescence and even in childhood. At any age, pharmacotherapy, along with enhancement of social skills and family support, is the mainstay for the management of such disorders. The aim of this review is to critically analyze findings from randomized controlled trials (RCTs) that have investigated the clinical utility of second-generation antipsychotics (SGAs) for the treatment of early-onset schizophrenia and bipolar disorders. Eighteen studies were considered, all of which were unfortunately impaired by methodologic limitations, such as the paucity of long-term data and lack of a three-arm comparison (SGA vs SGA vs placebo).Nevertheless, the results of this review allow us to suggest the effectiveness of three SGAs (aripiprazole, olanzapine, and risperidone) in the short-term treatment of both early-onset schizophrenia and bipolar mania, although such agents show different safety profiles. The use of clozapine should be strictly limited to patients with non-affective, psychotic symptoms who do not respond to any of these three SGAs. In contrast, the use of quetiapine and ziprasidone in young patients with either affective or non-affective psychosis is not yet supported by evidence-based information.Given our findings, further studies are urgently required to identify the best treatment option(s) for pediatric bipolar disorder (especially the depressive phase) and the long-term management of early-onset schizophrenia.
Pediatric Drugs, 13(5) : 291-302
- Year: 2011
- Problem: Bipolar Disorders, Psychosis Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Atypical Antipsychotics (second generation)
McGorry, P. D., Cocks, J., Power, P., Burnett, P., Harrigan, S., Lambert, T.
Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms (EPSs) when treated with the doses of neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less toxic in this population. Here, we report the results of a biphasic open label trial designed to assess the efficacy, safety, and tolerability of low-dose (2-4mg/day) risperidone treatment in a group of 96 first-episode nonaffective psychosis patients. At the end of the trial, 62 of patients met the response criteria although approximately 80 had achieved a response at some time during the study. Reports of EPS remained low, and there were no dystonic reactions. We conclude that even at a dose of 2mg/day, risperidone was highly effective in reducing acute symptomatology in a real world sample of young first-episode psychosis patients. (copyright) 2011 Patrick D. McGorry et al.
Schizophrenia Research & Treatment, :
- Year: 2011
- Problem: Psychosis Disorders
- Type: Controlled clinical trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Biological Interventions (any)
, Atypical Antipsychotics (second generation)
Girgis, Ragy R., Merrill, David B., Vorel, Stanislav R., Kim, Edward, Portland, Kimberly, You, Min, Pikalov, Andrei, Whitehead, Richard, Lieberman, Jeffrey A.
We conducted a secondary analysis of a completed study of the differential efficacy and side effects of aripiprazole versus haloperidol in early-stage schizophrenia (ESS), a subpopulation of patients which does not include first episode or chronic patients. A subpopulation of 360 individuals with ESS were identified from a randomized, multi-center, double-blind study of 1294 individuals with schizophrenia at different stages of illness who were randomized to treatment with aripiprazole (ESS = 237) or haloperidol (ESS = 123) for one year. The primary outcome measure was response rate based on a 50% reduction of Positive and Negative Syndrome Scale (PANSS) total scores. Secondary outcomes included several efficacy and safety measures, as well as treatment discontinuation. More individuals in the aripiprazole group (48%) than in the haloperidol group (28%; p < 0.01) completed the study. Response rates were greater in the aripiprazole group (38% [N = 91]) than in the haloperidol group (22% [N = 27]; p < 0.01). Aripiprazole was associated with fewer extrapyramidal side effects. ESS subjects in the haloperidol group were more likely than those in the aripiprazole group to discontinue the study drug due to an adverse event other than worsening illness (29% and 11%, respectively; p < 0.01), and efficacy differences were reduced by interventions to mitigate side effects (decreasing antipsychotic dose with or without adding antiparkinsonian medication). Aripiprazole has a favorable efficacy/safety profile in ESS and appeared to be superior to haloperidol on a number of efficacy and safety outcomes. However, excessive dosing of the antipsychotic medications, in particular haloperidol, may have played an important role in accounting for the differences between aripiprazole and haloperidol in this study. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Psychiatric Research, 45(6) : 756-762
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Typical Antipsychotics (first generation)
, Atypical Antipsychotics (second generation)
Girgis, Ragy R., Phillips, Michael R., Li, Xiaodong, Li, Kejin, Jiang, Huiping, Wu, Chengjing, Duan, Naihua, Niu, Yajuan, Lieberman, Jeffrey A.
Background: Aims: Method: Results: Conclusions: The differential effects of so-called 'first- and second generation' antipsychotic medications, when given in the first episode, on the long-term outcome of schizophrenia remain to be elucidated.We compared the 9-year outcomes of individuals initially randomised to clozapine or chlorpromazine.One-hundred and sixty individuals with treatment-naive, first episode schizophrenia or schizophreniform disorder in a mental health centre in Beijing, China were randomised to clozapine or chlorpromazine treatment for up to 2 years,followed by up to an additional 7 years of naturalistic treatment. The primary outcome was remission status for individuals in each group.Individuals in both groups spent essentially equal amounts of time in each clinical state over the follow-up time period(remission, 78%; intermediate, 8%; relapse, 14%). There were no significant differences on other measures of illness severity. The clozapine group was more likely than the chlorpromazine group to remain on the medication to which they were originally assigned (26% v. 10%, P = 0.01). There were no significant differences between the two groups on other secondary efficacy outcomes.These findings support the comparability in effectiveness between antipsychotic medications but with slightly greater tolerability of clozapine in the treatment of first-episode psychosis.
British Journal of Psychiatry, 199(4) : 281-288
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
-
Treatment and intervention: Biological Interventions (any)
, Typical Antipsychotics (first generation)
, Atypical Antipsychotics (second generation)
Kayo, M., Tassell, I., Hiroce, V. Y., Menezes, A. K., Oliveira, G. M., Iso, S., Elkis, H.
Background: Recent reviews have led to the hypothesis of early-onset of action of antipsychotics in the treatment of schizophrenia, within the first 2 weeks of treatment. However, such data come mainly from randomized controlled trials in chronic schizophrenia.We assessed time to response to antipsychotics in subjects with recent onset schizophrenia in an outpatient setting. Methods: We conducted an open trial with patients with exacerbation of recent onset schizophrenia. Subjects were randomized to first generation antipsychotic (FGA) or second generation antipsychotic (SGA) and then assessed with PANSS at baseline and weeks 2, 4, 6, 8 and 12. We followed the IPAP algorithm (International Psychopharmacology Algorithm Project): monotherapy with an antipsychotic for 4-6 weeks, and in case of non response, patients should undergo another trial with a second antipsychotic for 4-6 weeks. If a patient does not respond to 2 antipsychotic trials, he/she is considered refractory and candidate to clozapine. Response was defined as 30% improvement of PANSS score in comparison with baseline. Remission was defined according to Andreasen's et al criteria. Results: Twenty-two patients were included (SGA = 12; FGA = 10); 17 completed the 12-week period of study. Baseline PANSS was 94,16 ((plus or minus)21,98).Mean age was 30,33 years ((plus or minus)7,9) and mean time since schizophrenia diagnosis was 1,5 year ((plus or minus)1,92).Mean duration os untreated disease was 1,6 year ((plus or minus)2,60). Completer analyses showed an initial improvement of at least 20% of the PANSS in 50% of the subjects; 41.2% responded in the first 4-6 weeks and 58.8% did not respond in the first 6 weeks. At 8-12 weeks, 76.5% have responded to the treatment and 23.5% have not. Nine patients achieved remission; 12 did not respond to the first antipsychotic and switched to a second one; 9 (75%) responded to the second antipsychotic. A regression analysis using the general linear model with time as a factor, showed a significant improvement at PANSS only at week 8. No differences were observed between FGA and SGA. Initial improvement of at least 20% at PANSS in the first 2 weeks was not related with response or remission rates at week 12. Conclusion: In this small open pilot trial we did not observe a rapid response to antipsychotic but a cumulative higher response rate over time. Initial improvement did not predict better response.
Schizophrenia Bulletin, 37 : 309
- Year: 2011
- Problem: Psychosis Disorders
- Type: Controlled clinical trials
-
Stage: First episode (psychosis only)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Typical Antipsychotics (first generation)
, Atypical Antipsychotics (second generation)
Grootens, K. P., vanVeelen, N. M. J., Peuskens, J., Sabbe, B. G. C., Thys, E., Buitelaar, J. K., Verkes, R. J., Kahn, R. S.
Introduction: Head-to-head comparisons of antipsychotics have predominantly included patients with chronic conditions. The aim of the present study was to compare the efficacy and tolerability of ziprasidone and olanzapine in patients with recent-onset schizophrenia. Methods: The study was an 8-week, double-blind, parallel-group, randomized, controlled multicenter trial (NCT00145444). Seventy-six patients with schizophreniform disorder, schizophrenia or schizoaffective disorder (diagnosis < 5 y), and a maximum lifetime antipsychotic treatment <16 weeks participated in the study. Efficacy of ziprasidone (80–160 mg/d) and olanzapine 10–20 mg was measured using the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression (CGI) Scale, the Calgary Depression Scale for Schizophrenia (CDSS), and the Heinrich Quality of Life Scale (HQLS); tolerability assessments included laboratory assessments, body weight, and electroencephalogram. Results: Olanzapine (n = 34) and ziprasidone (n = 39) showed equal efficacy as measured by the PANSS, CDSS, CGI, and HQLS. However, mean weight gain was significantly higher in the olanzapine group (6.8 vs 0.1 kg, P < .001). Ziprasidone was associated with decreasing levels of triglycerides, cholesterol, and transaminases, while these parameters increased in the olanzapine group (all P values < .05). There were no significant differences in fasting glucose and prolactin levels or in cardiac or sexual side effects. Patients on ziprasidone used biperiden for extrapyramidal side effects more frequently (P < .05). Discussion: The results of this study indicate that ziprasidone and olanzapine have comparable therapeutic efficacy but differ in their side effect profile. However, there is a risk of a type II error with this sample size. Clinically significant weight gain and laboratory abnormalities appear early after initiating treatment and are more prominent with olanzapine, while more patients on ziprasidone received anticholinergic drugs to treat extrapyramidal symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Schizophrenia Bulletin, 37(Suppl 2) : 352-361
- Year: 2011
- Problem: Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Atypical Antipsychotics (second generation)