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Rehospitalization Risk with Second-Generation and Depot Antipsychotics

Rehospitalization Risk with Second-Generation and Depot Antipsychotics Decreasing hospital admissions is important for improving outcomes for people with schizophrenia. Second-generation antipsychotics (SGAs) are better tolerated for long-term therapy than traditional medications and may contribute to a lower rehospitalization risk, but have not been compared to depot forms with regard to long-term outcomes. This study evaluates the risk of readmission in patients discharged from six State of Maryland inpatient mental health facilities between Jan. 1, 1997 and Dec. 31, 1997 on clozapine (N = 41), risperidone (N = 149), and olanzapine (N = 103). These patients were compared with those discharged from the two largest state facilities during the same time period on fluphenazine decanoate (N = 59) or haloperidol decanoate (N = 59). One-year readmission risk (measured by Kaplan–Meier survival analysis with Holm's adjustment for multiple comparison on Log Rank tests) were 10% for clozapine, 12% for risperidone, and 13% for olanzapine. These risks were not significantly lower than the readmission risk for fluphenazine decanoate (21%) but were significantly lower than haloperidol decanoate (35%) for all three SGAs. Demographic and clinical variables did not predict readmission for any of the medications. In patients with similar demographic and clinical characteristics, 1-year risk of readmission for patients treated with SGAs were at least comparable to the 1-year risk for patients receiving fluphenazine decanoate and lower than the risk for patients treated with haloperidol decanoate. SGAs may provide better long-term prognoses and outcomes for patients with schizophrenia. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Clinical Psychiatry Springer Journals

Rehospitalization Risk with Second-Generation and Depot Antipsychotics

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Publisher
Springer Journals
Copyright
Copyright © 2003 by American Academy of Clinical Psychiatrists
Subject
Medicine & Public Health; Neurology; Psychiatry; Psychopharmacology
ISSN
1040-1237
eISSN
1573-3238
DOI
10.1023/A:1023276509470
Publisher site
See Article on Publisher Site

Abstract

Decreasing hospital admissions is important for improving outcomes for people with schizophrenia. Second-generation antipsychotics (SGAs) are better tolerated for long-term therapy than traditional medications and may contribute to a lower rehospitalization risk, but have not been compared to depot forms with regard to long-term outcomes. This study evaluates the risk of readmission in patients discharged from six State of Maryland inpatient mental health facilities between Jan. 1, 1997 and Dec. 31, 1997 on clozapine (N = 41), risperidone (N = 149), and olanzapine (N = 103). These patients were compared with those discharged from the two largest state facilities during the same time period on fluphenazine decanoate (N = 59) or haloperidol decanoate (N = 59). One-year readmission risk (measured by Kaplan–Meier survival analysis with Holm's adjustment for multiple comparison on Log Rank tests) were 10% for clozapine, 12% for risperidone, and 13% for olanzapine. These risks were not significantly lower than the readmission risk for fluphenazine decanoate (21%) but were significantly lower than haloperidol decanoate (35%) for all three SGAs. Demographic and clinical variables did not predict readmission for any of the medications. In patients with similar demographic and clinical characteristics, 1-year risk of readmission for patients treated with SGAs were at least comparable to the 1-year risk for patients receiving fluphenazine decanoate and lower than the risk for patients treated with haloperidol decanoate. SGAs may provide better long-term prognoses and outcomes for patients with schizophrenia.

Journal

Annals of Clinical Psychiatry – Springer Journals

Published: Oct 11, 2004

References

  • Can psychiatrists predict the one-year outcome of schizophrenia?
    Atakan, Z; Cliff, G; Cooper, JE
  • Assessing clinical predictions of early rehospitalization in schizophrenia
    Olfson, M; Mechanic, D; Boyer, CA; Hansell, S; Walkup, J; Weiden, PJ
  • Psychiatric status, quality of life, and level of care as predictors of outcomes of acute inpatient treatment
    Russo, J; Roy-Byrne, P; Jaffe, C; Ries, R; Dagadakis, C; Avery, D
  • Symptom severity and number of previous psychiatric admissions as predictors of readmission
    Swett, C
  • Relapse in schizophrenia: Is there a relationship to substance abuse?
    Gupta, S; Hendricks, S; Kenkel, AM; Bhatia, SC; Haffke, EA
  • Identifying modifiable risk factors for rehospitalization: A case control study of seriously mental ill persons in Mississippi
    Sullivan, G; Wells, KB; Morgenstern, H; Leake, B
  • Therapeutic alliance and outcome in a VA intensive case management program
    Neale, MS; Rosenheck, RA
  • The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients
    Vaughn, CE; Leff, JP
  • Atypical antipsychotic drugs and long-term outcome in schizophrenia
    Weiden, P; Aquila, R; Standard, J
  • Depot neuroleptics in relapse prevention: Avantages and disadvantages
    Gerlach, J
  • Long-term depot antipsychotics. A risk–benefit assessment
    Barnes, TR; Curson, DA
  • Prevention of relapse in schizophrenia
    Schooler, NR; Levine, J; Severe, JB; Brauzer, B; DiMascio, A; Klerman, GL; Tuason, VB
  • Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology Consensus Conference in Siena, Italy
    Kane, JM; Aguglia, E; Altamura, AC; Ayuso, G. J.; Brunello, N; Fleischhacker, WW; Gaebel, W; Gerlach, J; Guelfi, JD; Kissling, W; Lapierre, YD; Lindstrom, E; Mendlewicz, J; Racagni, G; Carulla, LS; Schooler, NR
  • At issue: Translating research into practice: The Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations
    Lehman, AF; Steinwachs, DM
  • The Texas Medication Algorithm Project (TMAP) schizophrenia algorithms
    Miller, AL; Chiles, JA; Chiles, JK; Crismon, ML; Rush, AJ; Shon, SP
  • Utilization of depot neuroleptic medication in psychiatric inpatients
    Citrome, L; Levine, J; Allingham, B
  • Racial disparities in antipsychotic prescription patterns for patients with schizophrenia
    Kuno, E; Rothbard, AB
  • Choosing antipsychotic maintenance therapy—A naturalistic study
    Tavcar, R; Dernovsek, MZ; Zvan, V
  • New atypical antipsychotic medications
    Jibson, MD; Tandon, R
  • Towards the improvement of compliance: The significance of psycho-education and new antipsychotic drugs
    Gaebel, W
  • Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses
    Tran, PV; Dellva, MA; Tollefson, GD; Wently, AL; Beasley, CM
  • Rehospitalization rates of patients recently discharged on a regimen of risperidone or clozapine
    Conley, RR; Love, RC; Kelly, DL; Bartko, JJ
  • Clozapine's effectiveness for patients in state hospitals: Results from a randomized trial
    Essock, SM; Hargreaves, WA; Covell, NH; Goethe, J
  • Prevention of relapse in chronic schizophrenic patients
    Hogarty, GE
  • Rehospitalization rates of chronically ill schizophrenic patients discharged on a regimen of risperidone, olanzapine, or conventional antipsychotics
    Rabinowitz, J; Licthenberg, P; Kaplan, Z; Mark, M; Nahon, D; Davidson, M
  • The limitations of antipsychotic medication on schizophrenia relapse and adjustment and the contributions of psychosocial treatment
    Hogarty, GE; Ulrich, RF
  • Relapse and rehospitalization during maintenance treatment of schizophrenia. The effects of dose reduction and family treatment
    Schooler, NR; Keith, SJ; Severe, JB; Matthews, SM; Bellack, AS; Glick, ID; Hargreaves, WA; Kane, JM; Ninan, PT; Frances, A; Jacobs, M; Lieberman, JA; Mance, R; Simpson, GM; Woerner, MG
  • Rehospitalization rates for depot antipsychotics and pharmacoeconomic implications: Comparison with risperidone
    Moore, DB; Kelly, DL; Sherr, JD; Love, RC; Conley, RR
  • Nonparametric estimation from incomplete observations
    Kaplan, EL; Meier, P
  • Linear rank tests with right censored data
    Prentice, RL
  • Regression models with life tables
    Cox, DR
  • Adjusting for multiple testing when reporting research results: The Bonferroni vs
    Aickin, M; Gensler, H
  • Clozapine for the treatment-resistant schizophrenic
    Kane, J; Honigfeld, G; Singer, J; Meltzer, H
  • Evaluation of treatment-resistant schizophrenia
    Conley, RR; Buchanan, RW
  • The effects of risperidone on the five dimensions of schizophrenia derived by factor analysis: Combined results of the North American trials
    Marder, SR; Davis, JM; Chouinard, G
  • Negative symptoms: A path analytic approach to a double-blind, placebo-and haloperidol-controlled clinical trial with olanzapine
    Tollefson, GD; Sanger, TM
  • One-year rehospitalization rates of patients discharged on atypical versus conventional antipsychotics
    Patel, NC; Dorson, PG; Edwards, N; Mendelson, S; Crismon, ML
  • The Risperidone Outcomes Study of Effectiveness (ROSE): A model for evaluating treatment strategies in typical psychiatric practice
    Mahmoud, R; Engelhart, L; Ollendorf, D; Oster, G
  • Switching from depot antipsychotics to risperidone: Results of a study of chronic schizophrenia. The schizophrenia treatment and assessment group
    Desai, NM; Huq, Z; Martin, SD; McDonald, G
  • Haloperidol decanoate v. fluphenazine decanoate as maintenance therapy in chronic schizophrenic in-patients
    McKane, JP; Robinson, AD; Wiles, DH; McCreadie, RG; Stirling, GS
  • Movement disorders in patients treated with long-acting injectable antipsychotic drugs
    Bransgrove, LL; Kelly, NW
  • Genetic polymorphism of drug metabolism enzymes in African populations: Implications for the use of neuroleptics and antidepressants
    Masimiremba, CM; Hasler, JA
  • Geographical/interracial differences in polymorphic drug oxidation, current state of knowledge of cytochromes P450 (CYP) 2D6 and 2C19
    Bertilsson, L
  • Factors affecting compliance with depot injection treatment in the community
    Tunnicliffe, S; Harrison, G; Standen, PJ
  • Race, quality of care, and antipsychotic prescribing practices in psychiatric emergency services
    Segal, SP; Bola, JR; Watson, MA
  • Race and tardive dyskinesia among outpatients at a CMHC
    Glazer, WM; Morganstern, H; Doucette, J
  • The expert consensus guideline series