조현병 환자에서 항정신병약물 유지치료 시 치료결과에 대한 연구
A Study on Discontinuation Rate on Maintenance Treatment of Antipsychotic Agents in Schizophrenic Patients
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Objectives : Relapse prevention is a major therapeutic goal in the treatment of schizophrenia. However, many patients experience multiple functional impairments and treatment resistance due to recurrence. This study was designed to investigate the follow-up of patients with using antipsychotic drugs and to compare the total treatment failure rate, withdrawal reasons, and duration period of antipsychotic drugs. Methods :IThe subjects were 1963 patients who taking antipsychotic drugs under the diagnosis of schizophrenia. We selected 1836 patients using 10 antipsychotic drugs according to frequency of using. The rate of total treatment failure of them was divided into 6-month, 1-year, 2-year, 3-year, and 5-year according to the time of drug withdrawal. We compared the total treatment failure rate at 1 and 3-year between 10 antipsychotic drugs. Results : The total treatment failure rate of clozapine was lowest compared with the other 9 antipsychotic drugs in all the surveyed periods. When evaluating actual number of subjects, olanzapine, sulpiride, risperidone, aripiprazole, amisulpride, and haloperidol were lower significantly compared with ziprasidone at 1-year in the total treatment failure rate, but there was no significant difference between them except clozapine at 3-year. The results of the analysis based on the number of prescriptions showed that the total treatment failure rate of the atypical antipsychotic drug was lower than that of the typical antipsychotic drug at 1-year, but the difference was decreased over time except quetiapine and ziprasidone. Conclusion : In conclusion, although there is some controversy about which drug to prescribe to the patient, the clinician needs a proper prescription considering various factors such as efficacy, side effects, price, and formulations of each drug.
Abstract
Objectives : Relapse prevention is a major therapeutic goal in the treatment of schizophrenia. However, many patients experience multiple functional impairments and treatment resistance due to recurrence. This study was designed to investigate the follow-up of patients with using antipsychotic drugs and to compare the total treatment failure rate, withdrawal reasons, and duration period of antipsychotic drugs. Methods :IThe subjects were 1963 patients who taking antipsychotic drugs under the diagnosis of schizophrenia. We selected 1836 patients using 10 antipsychotic drugs according to frequency of using. The rate of total treatment failure of them was divided into 6-month, 1-year, 2-year, 3-year, and 5-year according to the time of drug withdrawal. We compared the total treatment failure rate at 1 and 3-year between 10 antipsychotic drugs. Results : The total treatment failure rate of clozapine was lowest compared with the other 9 antipsychotic drugs in all the surveyed periods. When evaluating actual number of subjects, olanzapine, sulpiride, risperidone, aripiprazole, amisulpride, and haloperidol were lower significantly compared with ziprasidone at 1-year in the total treatment failure rate, but there was no significant difference between them except clozapine at 3-year. The results of the analysis based on the number of prescriptions showed that the total treatment failure rate of the atypical antipsychotic drug was lower than that of the typical antipsychotic drug at 1-year, but the difference was decreased over time except quetiapine and ziprasidone. Conclusion : In conclusion, although there is some controversy about which drug to prescribe to the patient, the clinician needs a proper prescription considering various factors such as efficacy, side effects, price, and formulations of each drug.
참고문헌 (22)
- Pincus HA, "From PORT to policy to patient outcomes: crossing the quality chasm", Schizophr Bull, 36, pp.109~111 (2010)
- Huang SS, "Antipsychotic formulation and one-year rehospitalization of schizophrenia patients: a population-based cohort study", Psychiatr Serv, 64, pp.1259~1262 (2013)
- Gitlin M, "Clinical outcome following neuroleptic discontinuation in patients with remitted recent-onset schizophrenia", Am J Psychiatry, 158, pp.1835~1842 (2001)
- Kane JM, "A 28-week, randomized, double-blind study of olanzapine versus aripiprazole in the treatment of schizophrenia", J Clin Psychiatry, 70, pp.572~581 (2009)
- Stroup TS, "Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic", Am J Psychiatry, 163, pp.611~622 (2006)
- Leucht S, "Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis", Lancet, 382, pp.951~962 (2013)
- Kahn RS, "Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial", Lancet, 371, pp.1085~1097 (2008)
- Nyhuis AW, "Predictors of switching antipsychotic medications in the treatment of schizophrenia", BMC Psychiatry, 10, pp.75~ (2010)
- Kane JM, "Non-adherence to medication in patients with psychotic disorders: epidemiology, contributing factors and management strategies", World Psychiatry, 12, pp.216~226 (2013)
- Goff DC, "Strategies for improving treatment adherence in schizophrenia and schizoaffective disorder", J Clin Psychiatry, 71(Suppl 2), pp.20~26 (2010)
- Harrison G, "Recovery from psychotic illness: a 15- and 25-year international follow-up study", Br J Psychiatry, 178, pp.506~517 (2001)
- American Psychiatric Association, "The diagnostic and statistical manual of mental disorder" (1994), American Psychiatric Press
- Ascher-Svanum H, "Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care", J Clin Psychiatry, 67, pp.453~460 (2006)
- Ascher-Svanum H, "The cost of relapse and the predictors of relapse in the treatment of schizophrenia", BMC Psychiatry, 10, pp.2~ (2010)
- Peuskens J, "Treatment retention with risperidone long-acting injection:24-month results from the Electronic Schizophrenia Treatment Adherence Registry (e-STAR) in six countries", Curr Med Res Opin, pp.501~509 (2010)
- Canadian Psychiatric Association, "Clinical practice guidelines. Treatment of schizophrenia", Can J Psychiatry, 50(Suppl 1), pp.7~57 (2005)
- Geddes J, "Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis", BMJ, 321, pp.1371~1376 (2000)
- Lehman AF, "Practice guideline for the treatment of patients with schizophrenia, second edition", Am J Psychiatry, 161, pp.1~56 (2004)
- Lieberman JA, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia", N Engl J Med, 353, pp.1209~1223 (2005)
- Mullins CD, "Risk of discontinuation of atypical antipsychotic agents in the treatment of schizophrenia", Schizophr Res, 98, pp.8~15 (2008)
- Lieberman JA, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia", N Engl J Med, 353, pp.1209~1223 (2005)
- Voruganti L, "Switching from conventional to novel antipsychotic drugs: results of a prospective naturalistic study", Schizophr Res, 57, pp.201~208 (2002)