Evidence map›Paper›PMID 25786408›Full record

ReviewSchizophrenia bulletin2015

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.

Stefan Leucht, Inge Winter-van Rossum, Stephan Heres, Celso Arango, W Wolfgang Fleischhacker, Birte Glenthøj, Marion Leboyer, F Markus Leweke, Shôn Lewis, Phillip McGuire and 5 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Schizophrenia bulletin, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  6. Amisulpride versus other atypical antipsychotics for schizophrenia.The Cochrane database of systematic reviews · 2010
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Stefan LeuchtDepartment of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, München, Germany; Stefan.Leucht@lrz.tum.de.
Inge Winter-van RossumDepartment of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands;
Stephan HeresDepartment of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, München, Germany;
Celso ArangoChild and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain;
W Wolfgang FleischhackerBiological Psychiatry Division, Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria;
Birte GlenthøjCenter for Neuropsychiatric Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Hospital Center Glostrup, Glostrup, Denmark;
Marion LeboyerINSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France, Fondation FondaMental;
F Markus LewekeCentral Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;
Shôn LewisUniversity of Manchester, Manchester, UK;
Phillip McGuireDepartment of Psychological Medicine, King's College London, Institute of Psychiatry, London, UK;
Andreas Meyer-LindenbergCentral Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany;
Dan RujescuDepartment of Psychiatry, Psychotherapy and Psychosomatics Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Shitij KapurDepartment of Psychological Medicine, King's College London, Institute of Psychiatry, London, UK;
René S KahnDepartment of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands;
Iris E SommerDepartment of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands;

Funding

Medical Research Council G0701748
6 · The paper itself

Abstract

backgroundMost of the 13 542 trials contained in the Cochrane Schizophrenia Group's register just tested the general efficacy of pharmacological or psychosocial interventions. Studies on the subsequent treatment steps, which are essential to guide clinicians, are largely missing. This knowledge gap leaves important questions unanswered. For example, when a first antipsychotic failed, is switching to another drug effective? And when should we use clozapine? The aim of this article is to review the efficacy of switching antipsychotics in case of nonresponse. We also present the European Commission sponsored "Optimization of Treatment and Management of Schizophrenia in Europe" (OPTiMiSE) trial which aims to provide a treatment algorithm for patients with a first episode of schizophrenia.

methodsWe searched Pubmed (October 29, 2014) for randomized controlled trials (RCTs) that examined switching the drug in nonresponders to another antipsychotic. We described important methodological choices of the OPTiMiSE trial.

resultsWe found 10 RCTs on switching antipsychotic drugs. No trial was conclusive and none was concerned with first-episode schizophrenia. In OPTiMiSE, 500 first episode patients are treated with amisulpride for 4 weeks, followed by a 6-week double-blind RCT comparing continuation of amisulpride with switching to olanzapine and ultimately a 12-week clozapine treatment in nonremitters. A subsequent 1-year RCT validates psychosocial interventions to enhance adherence. DISCUSSION: Current literature fails to provide basic guidance for the pharmacological treatment of schizophrenia. The OPTiMiSE trial is expected to provide a basis for clinical guidelines to treat patients with a first episode of schizophrenia.

Indexed as

Outcome Assessment, Health CareAdultAmisulprideAntipsychotic AgentsBenzodiazepinesClinical Trials as TopicClinical Trials, Phase III as TopicDisease ManagementEuropeHumansMulticenter Studies as TopicOlanzapinePsychotic DisordersRandomized Controlled Trials as TopicSchizophreniaSulpirideAmisulprideAntipsychotic AgentsBenzodiazepinesOlanzapineSulpiridealgorithmamisulpridefirst episodenonresponseolanzapineschizophrenia

Identifiers

PMID25786408
PMCPMC4393704

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.