TITLE:
Predictors of Discontinuation of Antipsychotic Therapy in Patients with Acute Schizophrenia: A 1-Year Observational Study with More Than 1000 Patients
AUTHORS:
Michihiro Takahashi, Shinji Fujikoshi, Jumpei Funai, Levent Alev, Masaomi Iyo
KEYWORDS:
Predictor of Discontinuation, Antipsychotic Monotherapy, Long-Term Observational Study, Schizophrenia
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.4 No.4,
October
22,
2014
ABSTRACT: Discontinuation of antipsychotic therapy has been a significant clinical
issue among patients with schizophrenia, since the patients who discontinued
antipsychotic treatment showed worse clinical and functional outcomes, and
higher risks of relapse of schizophrenia symptoms and hospitalization. We
conducted a post-hoc analysis of a
post-marketing research with a 12-month follow-up period to identify the
predictors for discontinuation of antipsychotic monotherapy in Japan. This is a
prospective, naturalistic multicenter observational study, designed to evaluate
the discontinuation rates of olanzapine monotherapy and non-olanzapine
antipsychotic monotherapy in Japanese adult patients with acute schizophrenia.
Patients were treatment-naive, or had switched from other antipsychotics or
from poly-pharmacotherapy to oral antipsychotic monotherapy. We analyzed the
correlation of discontinuation of antipsychotic monotherapy with baseline
characteristics of patients. A total of 1089 patients (578 patients treated
with olanzapine and 511 with non-olanzapine antipsychotics) were eligible for
analysis. By the end of the 12-month study period, 614 patients (56.4%)
discontinued antipsychotic therapy. Multivariate logistic regression analyses
indicated significantly lower discontinuation rates in all patients treated
with antipsychotics: older age (Odds ratio [OR], 0.871; 95% confidence interval
[CI], 0.797 to 0.953; p = 0.003), outpatient status (OR, 0.508; 95% CI, 0.383
to 0.675; p