Trial reportPsychopharmacology2007
How effective is it to sequentially switch among Olanzapine, Quetiapine and Risperidone?--A randomized, open-label study of algorithm-based antipsychotic treatment to patients with symptomatic schizophrenia in the real-world clinical setting.
Trial report in Psychopharmacology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Switching antipsychotics versus continued current treatment in people with non-responsive schizophrenia.The Cochrane database of systematic reviews · 2025Pooled it
- Early Non-Response to Antipsychotic Treatment in Schizophrenia: A Systematic Review and Meta-Analysis of Evidence-Based Management Options.CNS drugs · 2023Pooled it
- Increasing antipsychotic dose versus switching antipsychotic for non response in schizophrenia.The Cochrane database of systematic reviews · 2018Pooled it
- Does lack of improvement in the first two weeks predict treatment resistance in recent-onset psychosis?Clinics (Sao Paulo, Brazil) · 2012Trial
- Onset of Action of Selected Second-Generation Antipsychotics (Pines)-A Systematic Review and Meta-Analyses.Biomedicines · 2022Review
- Switching Antipsychotics to Blonanserin in Patients with Schizophrenia: An Open-label, Prospective, Multicenter Study.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2019Article
- Switching and augmentation strategies for antipsychotic medications in acute-phase schizophrenia: latest evidence and place in therapy.Therapeutic advances in psychopharmacology · 2018Review
- Presynaptic Dopamine Capacity in Patients with Treatment-Resistant Schizophrenia Taking Clozapine: An [Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2017Article
- The SWITCH study: rationale and design of the trial.European archives of psychiatry and clinical neuroscience · 2016Article
- The optimization of treatment and management of schizophrenia in Europe (OPTiMiSE) trial: rationale for its methodology and a review of the effectiveness of switching antipsychotics.Schizophrenia bulletin · 2015Review
- Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective.Evidence-based mental health · 2014Review
- An open-label study of algorithm-based treatment versus treatment-as-usual for patients with schizophrenia.Neuropsychiatric disease and treatment · 2013Article
- Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States.Cost effectiveness and resource allocation : C/E · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleEvidence on sequential trial with atypical antipsychotics has been scarce.
objectivesWe conducted an algorithm-based antipsychotic pharmacotherapy. MATERIALS AND
methodsIn this open-label study, patients with schizophrenia (DSM-IV) were treated with antipsychotic monotherapy, step-by-step, with each trial lasting up to 8 weeks. At baseline, they were highly symptomatic to score more than 54 in the total Brief Psychiatric Rating Scale (BPRS(1-7)) score. When the posttreatment BPRS score was above 70% of the baseline, they were subsequently treated with another and up to three atypicals. Basically, anticholinergics were prohibited, and only adjunctive allowed was lorazepam. The secondary endpoint was a clinical status good enough to be discharged for 66 inpatients and a successful continuation therapy with the same antipsychotic agent for more than 6 months for 12 outpatients.
resultsThree groups of 26 patients each were randomized to Olanzapine, Quetiapine, or Risperidone. Thirty-nine (50%) responded to the first agent (Olanzapine16, Quetiapine9, Risperidone14), and 14 responded to the second. Only two showed response to the third, and 16 failed to respond to all three antipsychotics, with only 7 dropouts. Overall, there were 22 Olanzapine, 14 Quetiapine, and 19 Risperidone responders. Based on the secondary outcome, 20 Olanzapine-treated (average maximum dose, 15.4 mg), 10 Quetiapine-treated (418 mg), and 20 Risperidone-treated (4.10 mg) patients responded. The difference in response as the first choice was significant (p < 0.05). Relative doses of those failing to respond were comparable (Olanzapine 18.3 mg, Quetiapine 564 mg, Risperidone5.47 mg). Extrapyramidal symptoms did not change significantly.
conclusionsWhen the first atypical antipsychotic is inadequate, switching to the second is worth trying, although some remain treatment-refractory. Quetiapine may be inferior to Olanzapine and Risperidone in symptomatic patients.
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