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Discontinuation Difference Seen in Schizophrenia Drugs

Patients more likely to stop haloperidol than second-generation antipsychotics

FRIDAY, March 28 (HealthDay News) -- Patients with first-episode schizophrenia and schizophreniform disorder are significantly more likely to discontinue haloperidol than second-generation antipsychotic drugs, researchers report in the March 29 The Lancet.

Rene S. Kahn, M.D., of the University Medical Centre Utrecht in the Netherlands, and colleagues analyzed data from an open, randomized trial of patients with schizophrenia, schizophreniform disorder or schizoaffective disorder. In the study, 103 took low-dose haloperidol, 104 took amisulpride, 105 took olanzapine, 104 took quetiapine and 82 took ziprasidone. The primary outcome was all-cause discontinuation, and follow-up was at one year.

The researchers found that any-cause discontinuation was substantially lower in groups on second-generation drugs than in those on haloperidol, with hazard ratios compared to haloperidol at: amisulpride, 0.37; olanzapine, 0.28, quetiapine, 0.52; ziprasidone, 0.51. However, symptom reductions were similar across the groups.

"We conclude that although the high continuation rates for several of the second-generation antipsychotic drugs suggest that clinically meaningful long-term antipsychotic treatment is achievable in the first-episode of schizophrenia, it cannot be concluded that second-generation antipsychotic drugs are more efficacious than is haloperidol in the treatment of these patients," the authors write.

Funding for the study was provided by AstraZeneca, Pfizer and Sanofi-Aventis. Kahn and several of his co-authors disclosed financial relationships with a number of pharmaceutical companies.

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