Value Health
Department of Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles, CA, USA.
Published: March 2008
Objective: Using data in real-world clinical practice, this study aims to compare the health-care use patterns of patients with schizophrenia who use oral antipsychotics.
Methods: A total of 219,504 episodes of antipsychotic drug therapy initiated during the period from 2000 to 2002 were identified using data from the California Medicaid program. Four types of episodes were analyzed based on the patient's drug use history as far back as 1994: restarting therapy after a break in therapy using the same drug used in the preceding episode; switching therapy after a break in treatment using a different medication; switching therapy without a break in therapy; and augmentation. Health-care use patterns over a 1-year post-treatment period were analyzed using ordinary least squares (OLS) regressions, Cox proportional hazards models, and logistic regression.
Results: The impact of atypical antipsychotics on health-care use in the first post-treatment year varies by episode type. Patients switching to atypical medications generally cost significantly more than similar patients switching to a conventional antipsychotic. Olanzapine and risperidone, however, were associated with reductions in total costs relative to conventional antipsychotics when used in restart and augmentation episodes. Differences across all three second-generation antipsychotics were relatively small.
Conclusions: Small differences across the atypical antipsychotics suggest that these drugs are interchangeable, raising the question of whether drug costs could be reduced through selectively contracting for a preferred drug. Potential savings may be limited by several factors. First, most episodes of treatment are restart episodes. Switching these patients to a preferred drug may have clinical risk. Second, patients with schizophrenia switch and augment therapies frequently, thus quickly reducing the population of patients who could be effectively treated with a single preferred drug.
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http://dx.doi.org/10.1111/j.1524-4733.2007.00212.x | DOI Listing |
JMIR Ment Health
January 2025
Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.
Background: Digital mental health interventions (DMHIs) to monitor and improve the health of people with psychosis or bipolar disorder show promise; however, user engagement is variable, and integrated clinical use is low.
Objective: This prospectively registered systematic review examined barriers and facilitators of clinician and patient engagement with DMHIs, to inform implementation within real-world settings.
Methods: A systematic search of 7 databases identified empirical studies reporting qualitative or quantitative data about factors affecting staff or patient engagement with DMHIs aiming to monitor or improve the mental or physical health of people with psychosis or bipolar disorder.
J Clin Psychiatry
January 2025
Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, and Department of Psychiatry, New York University School of Medicine, New York, New York.
There are few established treatments for negative symptoms in schizophrenia, which persist in many patients after positive symptoms are reduced. Oxidative stress, inflammation, and epigenetic modifications involving histone deacetylase (HDAC) have been implicated in the pathophysiology of schizophrenia. Sulforaphane has antioxidant properties and is an HDAC inhibitor.
View Article and Find Full Text PDFJ Clin Psychiatry
January 2025
Division of Pharmacotherapy and Translational Science, College of Pharmacy, University of Texas at Austin, San Antonio, Texas.
To evaluate weight change with a combination of olanzapine and samidorphan (OLZ/SAM) versus olanzapine by pooling data across clinical studies. This study was an individual patient data (IPD) meta-analysis of clinical trial data. EMBASE, MEDLINE, and PsycInfo were searched for randomized clinical trials (≥12 weeks) in adults with schizophrenia or bipolar I disorder in which weight change from baseline was the primary or secondary end point.
View Article and Find Full Text PDFFront Psychiatry
January 2025
Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Background: This study aims to evaluate the intervention effect of intermittent Theta burst stimulation (iTBS) on bilateral dorsomedial prefrontal cortex (DMPFC) for negative symptoms in schizophrenia using functional near-infrared spectroscopy (fNIRS) to confirm the therapeutic significance of DMPFC in treating negative symptoms and provide new evidence for schizophrenia treatment and research.
Method: Thirty-nine schizophrenia patients with negative symptoms and mild cognitive impairment were randomly divided into a treatment group (n=20) and a control group (n=19). The treatment group received iTBS in bilateral DMPFC.
Front Psychiatry
January 2025
Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China.
Background: Previous evidence suggests that immune-inflammatory dysfunction plays an important role in metabolic disorder (MD) of patients with schizophrenia, yet studies on sex differences in the association between both are limited. The current study aimed to investigate sex differences in the association between MD and inflammatory cytokines in Han Chinese patients with chronic schizophrenia (CS).
Methods: This multicentre cross-sectional study was conducted in one general hospital and two psychiatric hospitals in Anhui Province, China.
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