Response and Relapse in Patients With Schizophrenia Treated With Olanzapine, Risperidone, Quetiapine, or Haloperidol: 12-Month Follow-Up of the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) Study
J Clin Psychiatry 2005;66(8):1021-1030
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: The primary aim of this study was to
compare the effectiveness of 12 months' treatment with
olanzapine, risperidone, quetiapine, or haloperidol in preventing
relapse of schizophrenia. The study also examined other measures
of clinical effectiveness and tolerability.
Method: Outpatients with schizophrenia (ICD-10
or DSM-IV), who initiated or changed antipsychotic treatment,
entered this 3-year, naturalistic, prospective, observational
study between November 2000 and December 2001. At baseline,
subsets of patients were prescribed monotherapy with olanzapine
(N = 3222), risperidone (N = 1116), quetiapine (N = 189), or
haloperidol (N = 256). Patients remaining on monotherapy were
assessed using the Clinical Global Impression-Schizophrenia
scale. Relapse rate was determined from the responder subset.
Treatment patterns, patient perception of treatment compliance,
substance and alcohol intake patterns, and treatment tolerability
were recorded. Results are based on 12-month treatment data.
Results: Compared to haloperidol-treated
patients, olanzapine- and risperidone-treated patients had
approximately 3 to 4 times higher odds of response at 12 months
(p <= .001) and 6 times lower odds of relapse (p <= .001 for
olanzapine-treated patients).Among patients treated with atypical
antipsychotics, olanzapine- and risperidone-treated patients had
lower odds of relapse (although the difference was not
significant at p <= .001) and significantly higher odds of
response (p <= .001) compared to quetiapine-treated patients.
The tolerability profile generally favored the atypical
antipsychotics over haloperidol.
Conclusion: These interim results support
the findings of randomized controlled trials and verify that in
this naturalistic study, patients treated with olanzapine or
risperidone monotherapy were less likely to experience relapse
than patients who received haloperidol. The clinical
effectiveness and tolerability profile varied significantly
between the atypical antipsychotics.