Metabolic syndrome and drug discontinuation in schizophrenia: A randomized trial comparing aripiprazole olanzapine and haloperidol

A. Parabiaghi, Mauro Tettamanti, Barbara D'Avanzo, Angelo Barbato, Eugenio Aguglia, Chiara Bufalino, Dario Cannavò, Liliana Gandolfo, Mariano Bassi, Arcadio Erlicher, Germana Agnetti, Giancarlo Breviario, Massimo Casacchia, Rocco Pollice, Paolo Pomero, Antonio Colotto, Samuele Manfrinati, Carlo I. Cattaneo, Giulio Corrivetti, Gaetano PintoLuigi Ferrannini, Maurizio Marcenaro, Marco Vaggi, Lucio Ghio, Werner Natta, Farida Ferrato, Antonio Francomano, Maddalena La Placa, Antonino Mastroeni, Danilo Rigamonti, Christian Groppi, Massimo Carlo Mauri, I. F. De Gaspari, M. Percudani, Rocco Luigi Picci, Laura Comino, Elena Paschetta, Rosaria Pioli, S. Bignotti, G. Smerieri, Emanuela Ghinaglia, E. Visani, Adelia Lucattini, E. Caverzasi, Roberto Colombo, Alice Cervetti, A. D'Aloise, Vincenzo Fricchione Parise, Vincenzo Florio, Aristotele Hadjichristos, A. Barbato, Barbara D'Avanzo, Alberto Parabiaghi, Mauro Tettamanti, Grazia Buratti, Lucia Buratti, Andrea De Micheli, K. Furlato, Simona D'Onofrio, Ilaria Mariannantoni, F. Rapisarda, Francesca Riccardi, Alessandra Ruberto, Irene Ruggirello, Ilaria Santini, Federica Trivelli, Angelida Ullo

Research output: Contribution to journalArticle

Abstract

Objective: To determine whether the prescription of aripiprazole, compared with olanzapine and haloperidol, was associated with a lower frequency of metabolic syndrome (MS) and treatment discontinuation at 1 year. Method: Patients were randomly assigned to be treated open-label and according to usual clinical practice with either aripiprazole, olanzapine, or haloperidol and followed up for 1 year. Results: Three hundred out-patients with persistent schizophrenia were recruited in 35 mental health services. The intention-to-treat (ITT) analysis found no significant differences in the rate of MS between aripiprazole (37%), olanzapine (47%), and haloperidol (42%). Treatment discontinuation for any cause was higher for aripiprazole (52%) than for olanzapine (33%; OR, 0.41; P = 0.004), or haloperidol (37%; OR, 0.51; P = 0.030). No significant difference was found between olanzapine and haloperidol. Time to discontinuation for any cause was longer for olanzapine than for aripiprazole (HR, 0.55; P <0.001). No significant differences were found between haloperidol and aripiprazole, or between olanzapine and haloperidol. Conclusion: The prescription of aripiprazole did not significantly reduce the rates of MS, but its treatment retention was worse. Aripiprazole cannot be considered the safest and most effective drug for maintenance treatment of schizophrenia in routine care, although it may have a place in antipsychotic therapy.

Original languageEnglish
Pages (from-to)63-75
Number of pages13
JournalActa Psychiatrica Scandinavica
Volume133
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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olanzapine
Haloperidol
Schizophrenia
Pharmaceutical Preparations
Prescriptions
Therapeutics
Intention to Treat Analysis
Aripiprazole
Mental Health Services
Antipsychotic Agents

Keywords

  • Adverse effects
  • Antipsychotic drugs
  • Clinical trial
  • Effectiveness

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Metabolic syndrome and drug discontinuation in schizophrenia : A randomized trial comparing aripiprazole olanzapine and haloperidol. / Parabiaghi, A.; Tettamanti, Mauro; D'Avanzo, Barbara; Barbato, Angelo; Aguglia, Eugenio; Bufalino, Chiara; Cannavò, Dario; Gandolfo, Liliana; Bassi, Mariano; Erlicher, Arcadio; Agnetti, Germana; Breviario, Giancarlo; Casacchia, Massimo; Pollice, Rocco; Pomero, Paolo; Colotto, Antonio; Manfrinati, Samuele; Cattaneo, Carlo I.; Corrivetti, Giulio; Pinto, Gaetano; Ferrannini, Luigi; Marcenaro, Maurizio; Vaggi, Marco; Ghio, Lucio; Natta, Werner; Ferrato, Farida; Francomano, Antonio; La Placa, Maddalena; Mastroeni, Antonino; Rigamonti, Danilo; Groppi, Christian; Mauri, Massimo Carlo; De Gaspari, I. F.; Percudani, M.; Picci, Rocco Luigi; Comino, Laura; Paschetta, Elena; Pioli, Rosaria; Bignotti, S.; Smerieri, G.; Ghinaglia, Emanuela; Visani, E.; Lucattini, Adelia; Caverzasi, E.; Colombo, Roberto; Cervetti, Alice; D'Aloise, A.; Parise, Vincenzo Fricchione; Florio, Vincenzo; Hadjichristos, Aristotele; Barbato, A.; D'Avanzo, Barbara; Parabiaghi, Alberto; Tettamanti, Mauro; Buratti, Grazia; Buratti, Lucia; De Micheli, Andrea; Furlato, K.; D'Onofrio, Simona; Mariannantoni, Ilaria; Rapisarda, F.; Riccardi, Francesca; Ruberto, Alessandra; Ruggirello, Irene; Santini, Ilaria; Trivelli, Federica; Ullo, Angelida.

In: Acta Psychiatrica Scandinavica, Vol. 133, No. 1, 01.01.2016, p. 63-75.

Research output: Contribution to journalArticle

Parabiaghi, A, Tettamanti, M, D'Avanzo, B, Barbato, A, Aguglia, E, Bufalino, C, Cannavò, D, Gandolfo, L, Bassi, M, Erlicher, A, Agnetti, G, Breviario, G, Casacchia, M, Pollice, R, Pomero, P, Colotto, A, Manfrinati, S, Cattaneo, CI, Corrivetti, G, Pinto, G, Ferrannini, L, Marcenaro, M, Vaggi, M, Ghio, L, Natta, W, Ferrato, F, Francomano, A, La Placa, M, Mastroeni, A, Rigamonti, D, Groppi, C, Mauri, MC, De Gaspari, IF, Percudani, M, Picci, RL, Comino, L, Paschetta, E, Pioli, R, Bignotti, S, Smerieri, G, Ghinaglia, E, Visani, E, Lucattini, A, Caverzasi, E, Colombo, R, Cervetti, A, D'Aloise, A, Parise, VF, Florio, V, Hadjichristos, A, Barbato, A, D'Avanzo, B, Parabiaghi, A, Tettamanti, M, Buratti, G, Buratti, L, De Micheli, A, Furlato, K, D'Onofrio, S, Mariannantoni, I, Rapisarda, F, Riccardi, F, Ruberto, A, Ruggirello, I, Santini, I, Trivelli, F & Ullo, A 2016, 'Metabolic syndrome and drug discontinuation in schizophrenia: A randomized trial comparing aripiprazole olanzapine and haloperidol', Acta Psychiatrica Scandinavica, vol. 133, no. 1, pp. 63-75. https://doi.org/10.1111/acps.12468
Parabiaghi, A. ; Tettamanti, Mauro ; D'Avanzo, Barbara ; Barbato, Angelo ; Aguglia, Eugenio ; Bufalino, Chiara ; Cannavò, Dario ; Gandolfo, Liliana ; Bassi, Mariano ; Erlicher, Arcadio ; Agnetti, Germana ; Breviario, Giancarlo ; Casacchia, Massimo ; Pollice, Rocco ; Pomero, Paolo ; Colotto, Antonio ; Manfrinati, Samuele ; Cattaneo, Carlo I. ; Corrivetti, Giulio ; Pinto, Gaetano ; Ferrannini, Luigi ; Marcenaro, Maurizio ; Vaggi, Marco ; Ghio, Lucio ; Natta, Werner ; Ferrato, Farida ; Francomano, Antonio ; La Placa, Maddalena ; Mastroeni, Antonino ; Rigamonti, Danilo ; Groppi, Christian ; Mauri, Massimo Carlo ; De Gaspari, I. F. ; Percudani, M. ; Picci, Rocco Luigi ; Comino, Laura ; Paschetta, Elena ; Pioli, Rosaria ; Bignotti, S. ; Smerieri, G. ; Ghinaglia, Emanuela ; Visani, E. ; Lucattini, Adelia ; Caverzasi, E. ; Colombo, Roberto ; Cervetti, Alice ; D'Aloise, A. ; Parise, Vincenzo Fricchione ; Florio, Vincenzo ; Hadjichristos, Aristotele ; Barbato, A. ; D'Avanzo, Barbara ; Parabiaghi, Alberto ; Tettamanti, Mauro ; Buratti, Grazia ; Buratti, Lucia ; De Micheli, Andrea ; Furlato, K. ; D'Onofrio, Simona ; Mariannantoni, Ilaria ; Rapisarda, F. ; Riccardi, Francesca ; Ruberto, Alessandra ; Ruggirello, Irene ; Santini, Ilaria ; Trivelli, Federica ; Ullo, Angelida. / Metabolic syndrome and drug discontinuation in schizophrenia : A randomized trial comparing aripiprazole olanzapine and haloperidol. In: Acta Psychiatrica Scandinavica. 2016 ; Vol. 133, No. 1. pp. 63-75.
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abstract = "Objective: To determine whether the prescription of aripiprazole, compared with olanzapine and haloperidol, was associated with a lower frequency of metabolic syndrome (MS) and treatment discontinuation at 1 year. Method: Patients were randomly assigned to be treated open-label and according to usual clinical practice with either aripiprazole, olanzapine, or haloperidol and followed up for 1 year. Results: Three hundred out-patients with persistent schizophrenia were recruited in 35 mental health services. The intention-to-treat (ITT) analysis found no significant differences in the rate of MS between aripiprazole (37{\%}), olanzapine (47{\%}), and haloperidol (42{\%}). Treatment discontinuation for any cause was higher for aripiprazole (52{\%}) than for olanzapine (33{\%}; OR, 0.41; P = 0.004), or haloperidol (37{\%}; OR, 0.51; P = 0.030). No significant difference was found between olanzapine and haloperidol. Time to discontinuation for any cause was longer for olanzapine than for aripiprazole (HR, 0.55; P <0.001). No significant differences were found between haloperidol and aripiprazole, or between olanzapine and haloperidol. Conclusion: The prescription of aripiprazole did not significantly reduce the rates of MS, but its treatment retention was worse. Aripiprazole cannot be considered the safest and most effective drug for maintenance treatment of schizophrenia in routine care, although it may have a place in antipsychotic therapy.",
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T1 - Metabolic syndrome and drug discontinuation in schizophrenia

T2 - A randomized trial comparing aripiprazole olanzapine and haloperidol

AU - Parabiaghi, A.

AU - Tettamanti, Mauro

AU - D'Avanzo, Barbara

AU - Barbato, Angelo

AU - Aguglia, Eugenio

AU - Bufalino, Chiara

AU - Cannavò, Dario

AU - Gandolfo, Liliana

AU - Bassi, Mariano

AU - Erlicher, Arcadio

AU - Agnetti, Germana

AU - Breviario, Giancarlo

AU - Casacchia, Massimo

AU - Pollice, Rocco

AU - Pomero, Paolo

AU - Colotto, Antonio

AU - Manfrinati, Samuele

AU - Cattaneo, Carlo I.

AU - Corrivetti, Giulio

AU - Pinto, Gaetano

AU - Ferrannini, Luigi

AU - Marcenaro, Maurizio

AU - Vaggi, Marco

AU - Ghio, Lucio

AU - Natta, Werner

AU - Ferrato, Farida

AU - Francomano, Antonio

AU - La Placa, Maddalena

AU - Mastroeni, Antonino

AU - Rigamonti, Danilo

AU - Groppi, Christian

AU - Mauri, Massimo Carlo

AU - De Gaspari, I. F.

AU - Percudani, M.

AU - Picci, Rocco Luigi

AU - Comino, Laura

AU - Paschetta, Elena

AU - Pioli, Rosaria

AU - Bignotti, S.

AU - Smerieri, G.

AU - Ghinaglia, Emanuela

AU - Visani, E.

AU - Lucattini, Adelia

AU - Caverzasi, E.

AU - Colombo, Roberto

AU - Cervetti, Alice

AU - D'Aloise, A.

AU - Parise, Vincenzo Fricchione

AU - Florio, Vincenzo

AU - Hadjichristos, Aristotele

AU - Barbato, A.

AU - D'Avanzo, Barbara

AU - Parabiaghi, Alberto

AU - Tettamanti, Mauro

AU - Buratti, Grazia

AU - Buratti, Lucia

AU - De Micheli, Andrea

AU - Furlato, K.

AU - D'Onofrio, Simona

AU - Mariannantoni, Ilaria

AU - Rapisarda, F.

AU - Riccardi, Francesca

AU - Ruberto, Alessandra

AU - Ruggirello, Irene

AU - Santini, Ilaria

AU - Trivelli, Federica

AU - Ullo, Angelida

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective: To determine whether the prescription of aripiprazole, compared with olanzapine and haloperidol, was associated with a lower frequency of metabolic syndrome (MS) and treatment discontinuation at 1 year. Method: Patients were randomly assigned to be treated open-label and according to usual clinical practice with either aripiprazole, olanzapine, or haloperidol and followed up for 1 year. Results: Three hundred out-patients with persistent schizophrenia were recruited in 35 mental health services. The intention-to-treat (ITT) analysis found no significant differences in the rate of MS between aripiprazole (37%), olanzapine (47%), and haloperidol (42%). Treatment discontinuation for any cause was higher for aripiprazole (52%) than for olanzapine (33%; OR, 0.41; P = 0.004), or haloperidol (37%; OR, 0.51; P = 0.030). No significant difference was found between olanzapine and haloperidol. Time to discontinuation for any cause was longer for olanzapine than for aripiprazole (HR, 0.55; P <0.001). No significant differences were found between haloperidol and aripiprazole, or between olanzapine and haloperidol. Conclusion: The prescription of aripiprazole did not significantly reduce the rates of MS, but its treatment retention was worse. Aripiprazole cannot be considered the safest and most effective drug for maintenance treatment of schizophrenia in routine care, although it may have a place in antipsychotic therapy.

AB - Objective: To determine whether the prescription of aripiprazole, compared with olanzapine and haloperidol, was associated with a lower frequency of metabolic syndrome (MS) and treatment discontinuation at 1 year. Method: Patients were randomly assigned to be treated open-label and according to usual clinical practice with either aripiprazole, olanzapine, or haloperidol and followed up for 1 year. Results: Three hundred out-patients with persistent schizophrenia were recruited in 35 mental health services. The intention-to-treat (ITT) analysis found no significant differences in the rate of MS between aripiprazole (37%), olanzapine (47%), and haloperidol (42%). Treatment discontinuation for any cause was higher for aripiprazole (52%) than for olanzapine (33%; OR, 0.41; P = 0.004), or haloperidol (37%; OR, 0.51; P = 0.030). No significant difference was found between olanzapine and haloperidol. Time to discontinuation for any cause was longer for olanzapine than for aripiprazole (HR, 0.55; P <0.001). No significant differences were found between haloperidol and aripiprazole, or between olanzapine and haloperidol. Conclusion: The prescription of aripiprazole did not significantly reduce the rates of MS, but its treatment retention was worse. Aripiprazole cannot be considered the safest and most effective drug for maintenance treatment of schizophrenia in routine care, although it may have a place in antipsychotic therapy.

KW - Adverse effects

KW - Antipsychotic drugs

KW - Clinical trial

KW - Effectiveness

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