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Schizophr Res. 2008 Apr;101(1-3):312-9. doi: 10.1016/j.schres.2008.01.018. Epub 2008 Mar 4.

Predicting antipsychotic drug response - replication and extension to six weeks in an international olanzapine study.

Author information

1
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universität München, Ismaningerstr. 22, 81675 München, Germany. Stefan.Leucht@lrz.tum.de

Abstract

OBJECTIVE:

To use the degree of response after 2 weeks of treatment to predict non-response at 4 to 6 weeks.

METHOD:

Post-hoc re-analysis of a large multi-centered double-blind trial including 1996 patients with schizophrenia using receiver-operator curves and logistic regression analyses to predict non-response at 4 weeks and at 4-6 weeks from the percentage BPRS change at weeks 1 and 2. The primary non-response criterion was a less than 25% BPRS reduction from baseline.

RESULTS:

A 0% BPRS reduction at 2 weeks predicted non-response at 4 weeks with a positive predictive value of 77.1%; and sustained non-response at weeks 4, 5 and 6 with a positive predictive value of 75.8%. In a secondary last-observation-carried forward-analysis a less stringent cutoff of < or =15% BPRS reduction was associated with an acceptable positive predictive value (75%), with even higher sensitivity (76%).

CONCLUSIONS:

Those patients who showed little to no reduction of symptoms at week 2 were unlikely to show even minimal response at weeks 4 to 6. There is increasing evidence that such patients may benefit from a change in treatment.

PMID:
18308513
DOI:
10.1016/j.schres.2008.01.018
[Indexed for MEDLINE]

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