Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics
Abstract Background The aims of this study were to explore the relationship between early reduction in psychotic symptoms and the ultimate response in patients with schizophrenia treated by atypical antipsychotics, and to determine the best time to switch or maitain the regimen. We also explore the...
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doaj-1721653bb72e4c019e23046f4b9ced782020-11-25T01:18:33ZengBMCBMC Psychiatry1471-244X2018-12-011811810.1186/s12888-018-1950-1Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychoticsYi-Lung Chen0Kun-Po Chen1Chih-Chiang Chiu2Ming-Hong Tai3For-Wey Lung4Department of Biological Sciences, National Sun Yat-sen UniversityDepartment of Psychiatry, Taipei City Psychiatric Center, Taipei City HospitalDepartment of Psychiatry, Taipei City Psychiatric Center, Taipei City HospitalDepartment of Biological Sciences, National Sun Yat-sen UniversityCalo Psychiatric CenterAbstract Background The aims of this study were to explore the relationship between early reduction in psychotic symptoms and the ultimate response in patients with schizophrenia treated by atypical antipsychotics, and to determine the best time to switch or maitain the regimen. We also explore the possible predictors for the clinical response. Methods One hundred eleven inpatients with acutely exacerbated schizophrenia were randomized to give optimal therapy of olanzapine, risperidone, and paliperidone in one-week run-in period and 12 weeks’ intervention. All participants were assessed using Positive and Negative Syndrome Scale (PANSS). Early Response, defined as reduction of 25% in PANSS score, was examined at weeks 1, 2, 3, 4 and 8, and these ratings were used to predict ultimate response (25% PANSS reduction) at week 12. We hypothesized that early treatment response at Week 1 or 2 could predict Week 12’s treatment outcome. Results The early treatment response at Week 2 had a greater negative prediction value (NPV, 93.6%) than did the response at Week 1 (NPV, 69.7%), Week 3 (NPV, 91.5%), Week 4 (NPV, 90.7%) and Week 8 (NPV, 87.2%). The positive predictive value became more acceptable (65%) until Week 4. There was no any other potential predictors, including types of antipsychotics medication and treatment dosage, were associated with ultimate response in this study. Conclusion The treatment non-response at Week 2 optimally predicted the ultimate (Week 12) non-response, in terms of negative predictive value (NPV). These finding suggests that the revision of treatment strategy should be considered t if patients with schizophrenia was not responsive to them after 2 weeks’ treatment, and for those who are responders at Week 2, another two weeks are needed to further evaluate whether they will be continuously responsive. Trial registration NCT03730857 at ClinicalTrial.gov. Date of registration: 30/Oct/2018.http://link.springer.com/article/10.1186/s12888-018-1950-1SchizophreniaPANSSPositive predictive valueNegative predictive value |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yi-Lung Chen Kun-Po Chen Chih-Chiang Chiu Ming-Hong Tai For-Wey Lung |
spellingShingle |
Yi-Lung Chen Kun-Po Chen Chih-Chiang Chiu Ming-Hong Tai For-Wey Lung Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics BMC Psychiatry Schizophrenia PANSS Positive predictive value Negative predictive value |
author_facet |
Yi-Lung Chen Kun-Po Chen Chih-Chiang Chiu Ming-Hong Tai For-Wey Lung |
author_sort |
Yi-Lung Chen |
title |
Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics |
title_short |
Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics |
title_full |
Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics |
title_fullStr |
Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics |
title_full_unstemmed |
Early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics |
title_sort |
early predictors of poor treatment response in patients with schizophrenia treated with atypical antipsychotics |
publisher |
BMC |
series |
BMC Psychiatry |
issn |
1471-244X |
publishDate |
2018-12-01 |
description |
Abstract Background The aims of this study were to explore the relationship between early reduction in psychotic symptoms and the ultimate response in patients with schizophrenia treated by atypical antipsychotics, and to determine the best time to switch or maitain the regimen. We also explore the possible predictors for the clinical response. Methods One hundred eleven inpatients with acutely exacerbated schizophrenia were randomized to give optimal therapy of olanzapine, risperidone, and paliperidone in one-week run-in period and 12 weeks’ intervention. All participants were assessed using Positive and Negative Syndrome Scale (PANSS). Early Response, defined as reduction of 25% in PANSS score, was examined at weeks 1, 2, 3, 4 and 8, and these ratings were used to predict ultimate response (25% PANSS reduction) at week 12. We hypothesized that early treatment response at Week 1 or 2 could predict Week 12’s treatment outcome. Results The early treatment response at Week 2 had a greater negative prediction value (NPV, 93.6%) than did the response at Week 1 (NPV, 69.7%), Week 3 (NPV, 91.5%), Week 4 (NPV, 90.7%) and Week 8 (NPV, 87.2%). The positive predictive value became more acceptable (65%) until Week 4. There was no any other potential predictors, including types of antipsychotics medication and treatment dosage, were associated with ultimate response in this study. Conclusion The treatment non-response at Week 2 optimally predicted the ultimate (Week 12) non-response, in terms of negative predictive value (NPV). These finding suggests that the revision of treatment strategy should be considered t if patients with schizophrenia was not responsive to them after 2 weeks’ treatment, and for those who are responders at Week 2, another two weeks are needed to further evaluate whether they will be continuously responsive. Trial registration NCT03730857 at ClinicalTrial.gov. Date of registration: 30/Oct/2018. |
topic |
Schizophrenia PANSS Positive predictive value Negative predictive value |
url |
http://link.springer.com/article/10.1186/s12888-018-1950-1 |
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