Designing outcome studies to determine efficacy and safety of antipsychotics for real world treatment of schizophrenia

A. Carlo Altamura, Ira D. Glick

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Over the last 5 years, some studies have questioned the efficacy of second-generation antipsychotics over first-generation neuroleptics in the treatment of schizophrenia. At the same time, these study results have led to re-examination of their design - particularly CATIE and CUtLASS - which essentially measured relatively short-/mid-term outcome and did not always take into account real-world clinical practice and outcome measures (e.g. prevalence of positive acute symptoms, exclusion of comorbidity with substance abuse, predominance of chronic patients, lack of quality of life/wellbeing measures, etc.). In fact, one of the greatest challenges to treatment of schizophrenia is its life-long, multifaceted, functional disability associated with progressive cognitive deterioration after each acute episode. As such, the most important goal of the treatment is not just to deal with acute episodes, but rather to improve long-term outcome. Specifically, we aim for modest improvement and then stabilization of the different clinical dimensions involved in the overall symptomatology (i.e. negative/anergic, impulsive, positive, mood and cognitive impairments), and to achieve clinical stabilization after obtaining a partial or full remission of acute symptoms, thus reducing the risk of a progressive cognitive deterioration. All these aspects need to be properly evaluated in a long-run perspective.

Original languageEnglish
Pages (from-to)971-973
Number of pages3
JournalInternational Journal of Neuropsychopharmacology
Volume13
Issue number7
DOIs
Publication statusPublished - Aug 2010

Fingerprint

Antipsychotic Agents
Schizophrenia
Outcome Assessment (Health Care)
Safety
Time and Motion Studies
Substance-Related Disorders
Comorbidity
Therapeutics
Quality of Life
Cognitive Dysfunction

Keywords

  • Antipsychotics
  • outcome studies
  • schizophrenia

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Psychiatry and Mental health

Cite this

@article{7cfb6ce29fc5494693ac73b47d27815c,
title = "Designing outcome studies to determine efficacy and safety of antipsychotics for real world treatment of schizophrenia",
abstract = "Over the last 5 years, some studies have questioned the efficacy of second-generation antipsychotics over first-generation neuroleptics in the treatment of schizophrenia. At the same time, these study results have led to re-examination of their design - particularly CATIE and CUtLASS - which essentially measured relatively short-/mid-term outcome and did not always take into account real-world clinical practice and outcome measures (e.g. prevalence of positive acute symptoms, exclusion of comorbidity with substance abuse, predominance of chronic patients, lack of quality of life/wellbeing measures, etc.). In fact, one of the greatest challenges to treatment of schizophrenia is its life-long, multifaceted, functional disability associated with progressive cognitive deterioration after each acute episode. As such, the most important goal of the treatment is not just to deal with acute episodes, but rather to improve long-term outcome. Specifically, we aim for modest improvement and then stabilization of the different clinical dimensions involved in the overall symptomatology (i.e. negative/anergic, impulsive, positive, mood and cognitive impairments), and to achieve clinical stabilization after obtaining a partial or full remission of acute symptoms, thus reducing the risk of a progressive cognitive deterioration. All these aspects need to be properly evaluated in a long-run perspective.",
keywords = "Antipsychotics, outcome studies, schizophrenia",
author = "Altamura, {A. Carlo} and Glick, {Ira D.}",
year = "2010",
month = "8",
doi = "10.1017/S1461145709991271",
language = "English",
volume = "13",
pages = "971--973",
journal = "International Journal of Neuropsychopharmacology",
issn = "1461-1457",
publisher = "Cambridge University Press",
number = "7",

}

TY - JOUR

T1 - Designing outcome studies to determine efficacy and safety of antipsychotics for real world treatment of schizophrenia

AU - Altamura, A. Carlo

AU - Glick, Ira D.

PY - 2010/8

Y1 - 2010/8

N2 - Over the last 5 years, some studies have questioned the efficacy of second-generation antipsychotics over first-generation neuroleptics in the treatment of schizophrenia. At the same time, these study results have led to re-examination of their design - particularly CATIE and CUtLASS - which essentially measured relatively short-/mid-term outcome and did not always take into account real-world clinical practice and outcome measures (e.g. prevalence of positive acute symptoms, exclusion of comorbidity with substance abuse, predominance of chronic patients, lack of quality of life/wellbeing measures, etc.). In fact, one of the greatest challenges to treatment of schizophrenia is its life-long, multifaceted, functional disability associated with progressive cognitive deterioration after each acute episode. As such, the most important goal of the treatment is not just to deal with acute episodes, but rather to improve long-term outcome. Specifically, we aim for modest improvement and then stabilization of the different clinical dimensions involved in the overall symptomatology (i.e. negative/anergic, impulsive, positive, mood and cognitive impairments), and to achieve clinical stabilization after obtaining a partial or full remission of acute symptoms, thus reducing the risk of a progressive cognitive deterioration. All these aspects need to be properly evaluated in a long-run perspective.

AB - Over the last 5 years, some studies have questioned the efficacy of second-generation antipsychotics over first-generation neuroleptics in the treatment of schizophrenia. At the same time, these study results have led to re-examination of their design - particularly CATIE and CUtLASS - which essentially measured relatively short-/mid-term outcome and did not always take into account real-world clinical practice and outcome measures (e.g. prevalence of positive acute symptoms, exclusion of comorbidity with substance abuse, predominance of chronic patients, lack of quality of life/wellbeing measures, etc.). In fact, one of the greatest challenges to treatment of schizophrenia is its life-long, multifaceted, functional disability associated with progressive cognitive deterioration after each acute episode. As such, the most important goal of the treatment is not just to deal with acute episodes, but rather to improve long-term outcome. Specifically, we aim for modest improvement and then stabilization of the different clinical dimensions involved in the overall symptomatology (i.e. negative/anergic, impulsive, positive, mood and cognitive impairments), and to achieve clinical stabilization after obtaining a partial or full remission of acute symptoms, thus reducing the risk of a progressive cognitive deterioration. All these aspects need to be properly evaluated in a long-run perspective.

KW - Antipsychotics

KW - outcome studies

KW - schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=77957224689&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957224689&partnerID=8YFLogxK

U2 - 10.1017/S1461145709991271

DO - 10.1017/S1461145709991271

M3 - Article

C2 - 20128954

AN - SCOPUS:77957224689

VL - 13

SP - 971

EP - 973

JO - International Journal of Neuropsychopharmacology

JF - International Journal of Neuropsychopharmacology

SN - 1461-1457

IS - 7

ER -