tailieunhanh - Báo cáo y học: " Effectiveness of second-generation antipsychotics: a naturalistic, randomized comparison of olanzapine, quetiapine, risperidone, and ziprasidone"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Effectiveness of second-generation antipsychotics: a naturalistic, randomized comparison of olanzapine, quetiapine, risperidone, and ziprasidone | Johnsen et al. BMC Psychiatry 2010 10 26 http 1471-244X 10 26 BMC Psychiatry RESEARCH ARTICLE Open Access Effectiveness of second-generation antipsychotics a naturalistic randomized comparison of olanzapine quetiapine risperidone and ziprasidone Erik Johnsen 1 Rune A Kroken1 Tore Wentzel-Larsen2 Hugo A Jorgensen1 3 Abstract Background No clear recommendations exist regarding which antipsychotic drug should be prescribed first for a patient suffering from psychosis. The primary aims of this naturalistic study were to assess the head-to-head effectiveness of first-line second-generation antipsychotics with regards to time until drug discontinuation duration of index admission time until readmission change of psychopathology scores and tolerability outcomes. Methods Patients 18 years of age admitted to the emergency ward for symptoms of psychosis were consecutively randomized to risperidone n 53 olanzapine n 52 quetiapine n 50 or ziprasidone n 58 and followed for up to 2 years. Results A total of 213 patients were included of which 68 were males. The sample represented a diverse population suffering from psychosis. At admittance the mean Positive and Negative Syndrome Scale PANSS total score was 74 points and 44 were antipsychotic drug naive. The primary intention-to-treat analyses revealed no substantial differences between the drugs regarding the times until discontinuation of initial drug until discharge from index admission or until readmission. Quetiapine was superior to risperidone and olanzapine in reducing the PANSS total score and the positive subscore. Quetiapine was superior to the other drugs in decreasing the PANSS general psychopathology subscore in decreasing the Clinical Global Impression - Severity of Illness scale score CGI-S and in increasing the Global Assessment of Functioning - Split version Functions scale score GAF-F . Ziprasidone was superior to risperidone in decreasing the PANSS positive symptoms subscore and the CGI-S