Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia

Kenji Washida,1,2 Toshihiko Takeda,2 Toshiaki Habara,2 Soichiro Sato,2 Takuro Oka,2 Masuo Tanaka,2 Yusaku Yoshimura,2 Shozo Aoki11Department of Psychiatry, Kawasaki Medical Graduate School, Kurashiki, Japan; 2Zikei Hospital, Okayama, JapanAim: The aim of this study was to examine the speed of respon...

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Autores principales:	Washida K, Takeda T, Habara T, Sato S, Oka T, Tanaka M, Yoshimura Y, Aoki S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/a6adc00047184c62984b57107161f334
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spelling	oai:doaj.org-article:a6adc00047184c62984b57107161f3342021-12-02T04:36:40ZEfficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia1176-63281178-2021https://doaj.org/article/a6adc00047184c62984b57107161f3342013-06-01T00:00:00Zhttp://www.dovepress.com/efficacy-of-second-generation-antipsychotics-in-patients-at-ultra-high-a13398https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Kenji Washida,1,2 Toshihiko Takeda,2 Toshiaki Habara,2 Soichiro Sato,2 Takuro Oka,2 Masuo Tanaka,2 Yusaku Yoshimura,2 Shozo Aoki11Department of Psychiatry, Kawasaki Medical Graduate School, Kurashiki, Japan; 2Zikei Hospital, Okayama, JapanAim: The aim of this study was to examine the speed of response, doses, and safety of treatment with second-generation antipsychotics (SGAs) in patients at ultra-high risk (UHR) compared to those with schizophrenia.Methods: A 12-week open-label, prospective study of SGAs was performed in UHR patients and those with first-episode schizophrenia (FES) and multi-episode schizophrenia (MES). The subjects were 14–30 years old and were recruited at Zikei Hospital, Okayama, Japan from December 1, 2006 to December 1, 2011. Treatment was carried out in a natural setting in an open-label format, but clinical evaluation was performed blind. The clinical rating scales include the Global Assessment of Functioning (GAF), the Positive and Negative Syndrome Scale (PANSS), and the Clinical Global Impression-Severity scale (CGI-S).Results: UHR (n = 17), FES (n = 23), and MES (n = 21) patients all showed significant improvements on the GAF, PANSS, and CGI-S. However, the UHR patients showed significantly greater improvement on the GAF at weeks 4, 8, and 12 compared to the other groups, and a significantly lower modal dose of SGAs (chlorpromazine equivalent: 183 [201.1] mg/day, mean [SD]) was needed for improvement in the UHR group. Each group was also prescribed anticholinergic agents during the study period and the UHR group had significantly fewer extrapyramidal symptoms (only 6%) compared with the FES group.Conclusion: Our findings suggest that UHR patients have a better response to SGAs compared to patients with schizophrenia, and that these drugs can be given safely by minimizing the dosage of SGAs and using anticholinergic agents.Keywords: ultra-high risk, second-generation antipsychotics, schizophreniaWashida KTakeda THabara TSato SOka TTanaka MYoshimura YAoki SDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2013, Iss default, Pp 861-868 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Washida K Takeda T Habara T Sato S Oka T Tanaka M Yoshimura Y Aoki S Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia
description	Kenji Washida,1,2 Toshihiko Takeda,2 Toshiaki Habara,2 Soichiro Sato,2 Takuro Oka,2 Masuo Tanaka,2 Yusaku Yoshimura,2 Shozo Aoki11Department of Psychiatry, Kawasaki Medical Graduate School, Kurashiki, Japan; 2Zikei Hospital, Okayama, JapanAim: The aim of this study was to examine the speed of response, doses, and safety of treatment with second-generation antipsychotics (SGAs) in patients at ultra-high risk (UHR) compared to those with schizophrenia.Methods: A 12-week open-label, prospective study of SGAs was performed in UHR patients and those with first-episode schizophrenia (FES) and multi-episode schizophrenia (MES). The subjects were 14–30 years old and were recruited at Zikei Hospital, Okayama, Japan from December 1, 2006 to December 1, 2011. Treatment was carried out in a natural setting in an open-label format, but clinical evaluation was performed blind. The clinical rating scales include the Global Assessment of Functioning (GAF), the Positive and Negative Syndrome Scale (PANSS), and the Clinical Global Impression-Severity scale (CGI-S).Results: UHR (n = 17), FES (n = 23), and MES (n = 21) patients all showed significant improvements on the GAF, PANSS, and CGI-S. However, the UHR patients showed significantly greater improvement on the GAF at weeks 4, 8, and 12 compared to the other groups, and a significantly lower modal dose of SGAs (chlorpromazine equivalent: 183 [201.1] mg/day, mean [SD]) was needed for improvement in the UHR group. Each group was also prescribed anticholinergic agents during the study period and the UHR group had significantly fewer extrapyramidal symptoms (only 6%) compared with the FES group.Conclusion: Our findings suggest that UHR patients have a better response to SGAs compared to patients with schizophrenia, and that these drugs can be given safely by minimizing the dosage of SGAs and using anticholinergic agents.Keywords: ultra-high risk, second-generation antipsychotics, schizophrenia
format	article
author	Washida K Takeda T Habara T Sato S Oka T Tanaka M Yoshimura Y Aoki S
author_facet	Washida K Takeda T Habara T Sato S Oka T Tanaka M Yoshimura Y Aoki S
author_sort	Washida K
title	Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia
title_short	Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia
title_full	Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia
title_fullStr	Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia
title_full_unstemmed	Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia
title_sort	efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/a6adc00047184c62984b57107161f334
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Efficacy of second-generation antipsychotics in patients at ultra-high risk and those with first- episode or multi-episode schizophrenia

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