Switching between second-generation antipsychotics (SGAs) is a common clinical practice in the treatment of schizophrenia and schizoaffective disorders due to differences in the drugs' tolerability and safety profiles as well as the challenge of obtaining an ideal response. However, the factors associated with SGA switching remain uncertain and related real-world data are scarce. The main objective was to identify the factors associated with the switching of SGAs in patients with schizophrenia or schizoaffective disorder. We conducted a retrospective cohort study of outpatients with schizophrenia or schizoaffective disorder, who were aged ≥18 years and received a SGA (clozapine, olanzapine, risperidone, quetiapine or ziprasidone) from a Brazilian pharmaceutical assistance program for at least 3 months. We identified SGA users from 2008 to 2017 by using a national administrative database (Ambulatory Information System-SIA/SUS). The factors associated with the switches were evaluated by Cox proportional hazards regression and adjusted for sex and age; the confidence interval was set at 95% (95% CI). In total, 563,765 patients were included. Female sex, advanced age of ≥70 years, residence in the Brazilian northeast region, and the type of antipsychotic used were associated with an increased risk of switching ( < 0.001). The incidence of switching ranged from 37.6/100 person-years for clozapine users to 58.2/100 person-years for risperidone users. Compared to the adjusted hazard ratio, for clozapine users, the corresponding ratios for risperidone, ziprasidone, quetiapine and olanzapine were 1.59 (95% CI, 1.57-1.61), 1.41 (95% CI, 1.39-1.44), 1.25 (95% CI, 1.23-1.26) and 1.11 (95% CI, 1.10-1.12) respectively. The groups most susceptible to SGA switching in real-life setting were older individuals, women, and those living in the Brazilian northeast region. Risperidone was associated with the highest risk of switching and as expected, clozapine was associated with the lowest risk of switching than that associated with the other SGAs.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8201606 | PMC |
| http://dx.doi.org/10.3389/fphar.2021.638001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Role of psychologists in enhancing care quality for individuals with serious mental illnesses: Introduction to a special section.
Psychol Serv
February 2025
Yale University School of Medicine, Department of Psychiatry.
This special section underscores the importance of psychologists in improving and enhancing care for individuals with serious mental illnesses (SMIs). People with diagnoses typically included in the category of SMIs-schizophrenia, schizoaffective disorder, bipolar disorder, and other diagnoses with symptoms severely impacting functioning-typically have layered marginalities and experience significant social stigma in addition to mental health symptoms. The complexity of challenges commonly experienced by individuals with SMI requires that treatment providers have specialized knowledge, training, and skills to provide specialty care needed to support mental health recovery.
View Article and Find Full Text PDFBackground And Hypothesis: We have reported previously a reduction in superior temporal gyrus (STG) activation and in auditory verbal hallucinations (AHs) after real-time fMRI neurofeedback (NFB) in schizophrenia patients with AHs.
Study Design: With this randomized, participant-blinded, sham-controlled trial, we expanded our previous results. Specifically, we examined neurofeedback effects from the STG, an area associated with auditory hallucinations.
Characterizing the relationship between personality dimensions and psychosis-specific clinical characteristics.
Schizophr Res
January 2025
Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address:
Background: Past studies associating personality with psychosis have been limited by small nonclinical samples and a focus on general symptom burden. This study uses a large clinical sample to examine personality's relationship with psychosis-specific features and compare personality dimensions across clinically and neurobiologically defined categories of psychoses.
Methods: A total of 1352 participants with schizophrenia, schizoaffective disorder, and bipolar with psychosis, as well as 623 healthy controls (HC), drawn from the Bipolar-Schizophrenia Network for Intermediate Phenotypes (BSNIP-2) study, were included.
A Case Report: The Vicious Cycle of Schizophrenia, Substance Abuse, and Human Trafficking.
Cureus
December 2024
Psychiatry, LifeStream Behavioral Center, Leesburg, USA.
Patients with schizophrenia often find themselves in vulnerable situations because their cognitive impairments can make them more susceptible to exploitation and crime. A prevalent misconception is that schizophrenia is synonymous with violence, possibly fueled by selective media coverage that highlights instances of violent crimes involving individuals with schizophrenia. In reality, a large percentage of people with schizophrenia do not display violent behavior.
View Article and Find Full Text PDFDeciding to Be Left Alone After Being Left Out: Behavioral Responses to Social Exclusion in Schizophrenia.
Schizophr Bull
January 2025
Department of Psychology, University of California, Berkeley, CA 94720, United States.
Background And Hypotheses: People with schizophrenia are at risk for social exclusion, yet we know little about their responses. We hypothesized (1) people with schizophrenia would be more likely to withdraw following social exclusion compared to controls; (2) withdrawal intentions would be greater following exclusion compared to disappointment; (3) withdrawal behavior would be predicted by rejection sensitivity, alternative sources of acceptance, chronicity of exclusion, and perceived fairness; and (4) withdrawal following exclusion would be associated with more negative symptoms and poorer functioning.
Study Design: People with (n = 43) and without (n = 43) schizophrenia or schizoaffective disorder played Cyberball - Behavioral Response, a novel version of the exclusion task.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!