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Br J Psychiatry. 2017 Sep;211(3):137-143. doi: 10.1192/bjp.bp.116.186007. Epub 2017 May 18.

One-year symptom trajectories in patients with stable schizophrenia maintained on antipsychotics versus placebo: meta-analysis.

Author information

1
Hiroyoshi Takeuchi, MD, PhD, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, Department of Psychiatry, University of Toronto, Toronto, Canada, and Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Navot Kantor, BSc, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Marcos Sanches, MSc, Biostatistical Consulting Service, Clinical Research Department, Centre for Addiction and Mental Health, Toronto, Canada; Gagan Fervaha, BSc, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, and Institute of Medical Science, University of Toronto, Toronto, Canada; Ofer Agid, MD, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, Canada; Gary Remington, MD, PhD, FRCPC, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada hirotak@dk9.so-net.ne.jp.
2
Hiroyoshi Takeuchi, MD, PhD, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, Department of Psychiatry, University of Toronto, Toronto, Canada, and Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Navot Kantor, BSc, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Marcos Sanches, MSc, Biostatistical Consulting Service, Clinical Research Department, Centre for Addiction and Mental Health, Toronto, Canada; Gagan Fervaha, BSc, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, and Institute of Medical Science, University of Toronto, Toronto, Canada; Ofer Agid, MD, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, Canada; Gary Remington, MD, PhD, FRCPC, Schizophrenia Division, Complex Care & Recovery Program, Centre for Addiction and Mental Health, Toronto, Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.

Abstract

BackgroundAs definitions of relapse differ substantially between studies, in investigations involving data aggregation, total scores on clinical rating scales provide a more generalisable outcome.AimsTo compare total symptom trajectories for antipsychotic versus placebo treatment over a 1-year period of maintenance treatment in schizophrenia.MethodRandomised controlled trials with antipsychotic and placebo treatment arms in patients with stable schizophrenia that reported Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale total scores at more than one time point were included. Meta-regression analyses were employed using a mixed model.ResultsA total of 11 studies involving 2826 patients were included. Meta-regression analyses revealed significant interactions between group and time (PS<0.0001); both standardised total scores and per cent score changes remained almost unchanged in patients continuing antipsychotic treatment, whereas symptoms continuously worsened over time in those switching to placebo treatment.ConclusionsWhen considering long-term antipsychotic treatment of schizophrenia, clinicians must balance symptomatic and functional outcomes.

PMID:
28522434
DOI:
10.1192/bjp.bp.116.186007
[Indexed for MEDLINE]

Conflict of interest statement

Declaration of interestH.T. has received manuscript fees from Sumitomo Dainippon Pharma. O.A has received speaker's honoraria from Eli Lilly & Company USA, Eli Lilly Canada, Janssen-Ortho (Johnson & Johnson), Lundbeck, Mylan Pharmaceuticals, Novartis, Sepracor Inc. and Sunovion, and consultant fees from BMS, Eli Lilly & Company USA, Eli Lilly Canada, Janssen-Ortho (Johnson & Johnson), Lundbeck, Novartis, Otsuka, Roche, Sepracor Inc. and Sunovion, and research support from Boehringer Ingelheim, Neurocrine Biosciences, Janssen-Ortho (Johnson & Johnson), Otsuka, Pfizer Inc. and Sunovion. G.R. has received research support from Novartis, Medicure and Neurocrine Bioscience, consultant fees from Laboratorios Farmacéuticos ROVI, Synchroneuron and Novartis, and speaker's fees from Novartis.

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