NDLI: Clinical, Functional, and Economic Ramifications of Early Nonresponse to Antipsychotics in the Naturalistic Treatment of Schizophrenia

Content Provider	PubMed Central
Author	Haya, Ascher-svanum Nyhuis, Allen W. Faries, Douglas E. Kinon, Bruce J. Baker, Robert W. Shekhar, Anantha
Copyright Year	2008
Abstract	Objective: Early nonresponse to antipsychotics appears to predict subsequent nonresponse to treatment when assessed in randomized controlled trials of predominately acute inpatients treated for schizophrenia. This study assessed the predictive accuracy of early nonresponse to treatment and its clinical, functional, and economic ramifications in the naturalistic treatment of predominately chronic outpatients treated for schizophrenia. Methods: This post hoc analysis used data from a 1-year, randomized, open-label study of olanzapine, risperidone, and typical antipsychotics in the treatment of schizophrenia. If clinically warranted, patients could switch antipsychotics following 8 weeks of treatment. Patients completing 8 weeks of treatment (n = 443 of 664 enrollees) were included. Patients with early response (≥20% improvement from baseline on the Positive and Negative Syndrome Scale at 2 weeks) were compared with early nonresponders on symptom remission, functionality, perceptions of medication influence, and total health care costs at 8 weeks. Results: Early response/nonresponse at 2 weeks predicted subsequent response/nonresponse at 8 weeks with a high level of accuracy (72%) and specificity (89%). After 8 weeks, early nonresponders were less likely to achieve symptom remission (P < .001), improved less on functional domains (P < .05), perceived medication as less beneficial (P = .004), and incurred total heath care costs over twice that of early responders ($4349 vs $2102, P = .010). Conclusions: In the usual care of schizophrenia patients, early nonresponse appears to reliably predict subsequent nonresponse to continued treatment with the same medication to be associated with poorer outcomes and higher health care costs. Identifying early nonresponders may minimize prolonging exposure to suboptimal or ineffective treatment strategies.
Related Links	http://dx.doi.org/10.1093/schbul/sbm134
Ending Page	1171
Page Count	9
Starting Page	1163
File Format	PDF
ISSN	05867614
e-ISSN	17451701
Journal	Schizophrenia Bulletin
Issue Number	6
Volume Number	34
Language	English
Publisher	Oxford University Press
Publisher Date	2008-08-01
Access Restriction	Open
Rights Holder	Oxford University Press
Subject Keyword	Psychiatry and Mental health Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health

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