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Does drug use affect the efficacy of amisulpride, aripiprazole and olanzapine in patients with schizophrenia spectrum disorders? Results from a pragmatic, randomised study.
- Source :
-
General hospital psychiatry [Gen Hosp Psychiatry] 2023 Jul-Aug; Vol. 83, pp. 185-193. Date of Electronic Publication: 2023 May 08. - Publication Year :
- 2023
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Abstract
- Objectives: Drug use is prevalent in patients with schizophrenia spectrum disorders (SSD) but there is limited knowledge about the influence of drug use on the effectiveness of antipsychotic medication. This secondary explorative study compared the effectiveness of three antipsychotics in patients with SSD, with and without drug use.<br />Methods: The BeSt InTro multi-centre, head to head, rater-blinded randomised study compared amisulpride, aripiprazole and olanzapine over a 1-year follow-up period. All patients (n = 144) were aged ≥18 years and met the ICD-10 criteria for SSD (F20-29). Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). The primary outcome was reduction of a PANSS positive subscale score.<br />Results: At baseline, 38% of all patients reported drug use in the last 6 months before inclusion, with cannabis as the main drug (85%), followed by amphetamine-type stimulants (45%), sedatives (26%), hallucinogens (19%), cocaine (13%), opiates (4%), GHB (4%), solvents (4%), analgesics (4%) and anabolic steroids (2%). The predominant pattern was the use of several drugs. There were no significant overall differences in the PANSS positive subscale score reduction for the three studied antipsychotics among patients either with or without drug use. In the drug use group, older patients treated with amisulpride showed a greater PANSS positive subscale score reduction during the treatment period compared to younger patients.<br />Conclusion: The current study showed that drug use does not appear to affect the overall effectiveness of amisulpride, aripiprazole and olanzapine in patients with SSD. However, amisulpride may be a particularly suitable choice for older patients with drug use.<br />Competing Interests: Declaration of Competing Interest None.<br /> (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Adolescent
Adult
Olanzapine therapeutic use
Aripiprazole pharmacology
Aripiprazole therapeutic use
Amisulpride pharmacology
Amisulpride therapeutic use
Risperidone adverse effects
Benzodiazepines therapeutic use
Piperazines adverse effects
Thiazoles adverse effects
Treatment Outcome
Antipsychotic Agents adverse effects
Schizophrenia drug therapy
Clozapine adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1873-7714
- Volume :
- 83
- Database :
- MEDLINE
- Journal :
- General hospital psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 37269769
- Full Text :
- https://doi.org/10.1016/j.genhosppsych.2023.05.003