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Aripiprazole, Ziprasidone and Quetiapine in the treatment of first-episode nonaffective psychosis: A 12-week randomized, flexible-dose, open-label trial

AuthorsCrespo-Facorro, Benedicto; Mata, Ignacio; Ayesa-Arriola, Rosa; Valdizán, Elsa M. CSIC ORCID; Vázquez-Barquero, J. L.; Pérez-Iglesias, Rocío
Adverse effects
Psychotherapeutic processes
Antipsychotic agents
Issue Date2013
CitationSchizophrenia Research 147(2-3): 375-382 (2013)
Abstract[Background]: Differences among antipsychotics in terms of effectiveness have turned out to be a topic of increasing research interest, although comparisons between the different second generation antipsychotics (SGAs) are scarce. We aimed to compare the clinical effectiveness in the short-term of Aripiprazole, Ziprasidone and Quetiapine in the treatment of first-episode schizophrenia-spectrum disorders. [Method]: From October 2005 to January 2011, a prospective, randomized, open-label study was undertaken. 202 first-episode drug-naïve patients were randomly assigned to Aripiprazole (N = 78), Ziprasidone (N = 62), or Quetiapine (N = 62) and followed-up for 3. months. The primary effectiveness measure was all-cause of treatment discontinuation. In addition, an analysis based on intention-to-treat populations was conducted in the analysis for clinical efficacy. [Results]: The overall dropout rate at 3months was small (13.86%). The treatment discontinuation rate differed significantly between treatment groups (Aripiprazole = 23.1%, Ziprasidone = 37.1% and Quetiapine = 61.3%) (?2 = 21.334; p < 0.001). Insufficient efficacy in the group of Quetiapine is the main reason for discontinuation rate differences (?2 = 20.223; p <0.001). The mean time to all-cause discontinuation was significantly different between groups (LogRank = 23.467 p <0.001). Aripiprazole and Quetiapine were associated with a greater depressive symptoms improvement (p = 0.043). The profile of side-effects varies between treatments. Patients on Quetiapine were less likely to be prescribed hypnotics. [Conclusions]: Patients treated with Quetiapine had a higher risk of treatment discontinuation in the short-term after a first episode due to insufficient efficacy. Establishing differences between SGAs may help clinicians in prescribing decisions for the treatment of individuals presenting with first-episode schizophrenia.
Identifiersdoi: 10.1016/j.schres.2013.04.014
issn: 0920-9964
e-issn: 1573-2509
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