ArticleBMC medicine2005
Discontinuation of treatment of schizophrenic patients is driven by poor symptom response: a pooled post-hoc analysis of four atypical antipsychotic drugs.
Article in BMC medicine, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Non-verbal behaviours as predictors for treatment response in patients with depression or schizophrenia: a systematic review.Frontiers in psychiatry · 2025Pooled it
- Quetiapine versus typical antipsychotic medications for schizophrenia.The Cochrane database of systematic reviews · 2013Pooled it
- Improving adherence in mental health service users with severe mental illness in South Africa: a pilot randomized controlled trial of a treatment partner and text message intervention vs. treatment as usual.BMC research notes · 2017Trial
- Early response or nonresponse at week 2 and week 3 predict ultimate response or nonresponse in adolescents with schizophrenia treated with olanzapine: results from a 6-week randomized, placebo-controlled trial.European child & adolescent psychiatry · 2015Trial
- Long acting risperidone in Australian patients with chronic schizophrenia: 24-month data from the e-STAR database.BMC psychiatry · 2012Trial
- Early response predicts subsequent response to olanzapine long-acting injection in a randomized, double-blind clinical trial of treatment for schizophrenia.BMC psychiatry · 2011Trial
- The heterogeneity of antipsychotic response in the treatment of schizophrenia.Psychological medicine · 2011Trial
- Clinical and economic ramifications of switching antipsychotics in the treatment of schizophrenia.BMC psychiatry · 2009Trial
- Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia.BMC psychiatry · 2006Trial
- Clinical effects of CYP2D6 phenoconversion in patients with psychosis.Journal of psychopharmacology (Oxford, England) · 2024Article
- Real-world healthcare resource utilization, costs, and predictors of relapse among US patients with incident schizophrenia or schizoaffective disorder.Schizophrenia (Heidelberg, Germany) · 2024Article
- Antipsychotic-induced epigenomic reorganization in frontal cortex of individuals with schizophrenia.eLife · 2024Article
- Medication Nonadherence and Risk of Violence to Others Among Patients With Schizophrenia in Western China.JAMA network open · 2023Article
- In Silico Screening of Novel α1-GABAInternational journal of molecular sciences · 2021Article
- Plasma Lysophosphatidylcholine and Lysophosphatidylethanolamine Levels Were Associated With the Therapeutic Response to Olanzapine in Female Antipsychotics-naïve First-episode Patients With Schizophrenia.Frontiers in pharmacology · 2021Article
- Risk and protective factors of relapse in patients with first-episode schizophrenia from perspectives of health professionals: a qualitative study in northeastern Thailand.F1000Research · 2021Article
- Longitudinal trajectory analysis of antipsychotic response in patients with schizophrenia: 6-week, randomised, open-label, multicentre clinical trial.BJPsych open · 2020Article
- Assessment of Real-Life Outcomes in Schizophrenia Patients according to Compliance.Psychiatry journal · 2020Article
- Treatment Trends in Dry Eye Disease and Factors Associated with Ophthalmic Follow-up Discontinuation in Japan.Journal of clinical medicine · 2019Article
- HDAC2-dependent Antipsychotic-like Effects of Chronic Treatment with the HDAC Inhibitor SAHA in Mice.Neuroscience · 2018Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStopping antipsychotic treatment can interrupt improvement and exacerbate the illness. The reasons for discontinuing treatment during controlled clinical trials were analyzed to explore this phenomenon.
methodsA post-hoc, pooled analysis was made of 4 randomized, double-blind clinical trials, 24-28 weeks in duration, involving 1627 patients with schizophrenia or a related disorder. Analyses combined all the atypical antipsychotic treatment groups in the studies.
resultsThe majority of patients (53%) stopped their treatment at an early stage. Poor psychiatric response along with worsening symptoms was the most frequently given reason for discontinuing the course (36%), which was substantially more common than discontinuation due to poor tolerability of the medication (12%). This phenomenon was corroborated by less improvement in patients who discontinued treatment compared with those who completed, based on the PANSS total scores. Discontinuation due to poor response was, apparently, more predominantly linked to patient perception than to physicians' conclusions alone (80% vs. 20%). Discontinuation due to patient perception of poor response appeared to occur particularly early in the course of treatment. Patients who discontinued due to poor toleration of the medication responded in a more comparable manner with completers.
conclusionDiscontinuing treatment may lead to exacerbation of symptoms, undermining therapeutic progress. In these studies, poor response to treatment and worsening of underlying psychiatric symptoms, and to a lesser extent, intolerability to medication were the primary contributors to treatment being discontinued. Our findings suggest that adherence may be enhanced by effective symptom control, as objectively measured and as subjectively perceived. Such strategies may improve patients' willingness to undertake long-term therapy and increase the likelihood of a better prognosis.
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