Antipsychotic Maintenance Rx Aids Schizophrenia Patients

But benefits of antipsychotic maintenance therapy need to be weighed against risk of side effects

THURSDAY, May 3 (HealthDay News) -- Maintenance therapy with antipsychotic drugs is associated with a reduction in the relapse rate in schizophrenia, but benefits must be weighed against risks of adverse side effects, according to a review published online May 3 in The Lancet.

Stefan Leucht, M.D., from Technische Universität München in Munich, Germany, and colleagues reviewed the literature to assess the correlation between antipsychotic drugs and outcomes in schizophrenia. A total of 116 reports from 65 trials were identified, involving 6,493 patients. Relapse between seven and 12 months was the primary outcome assessed.

The researchers found that, compared with placebo treatment, relapse rates were significantly reduced at one year with antipsychotic drugs (27 versus 64 percent; risk ratio [RR], 0.40) and fewer patients given antipsychotic drugs were readmitted (10 versus 26 percent). Of the relapsed patients, less than a third had to be readmitted. From limited data there was a suggestion of better quality of life and fewer aggressive acts with antipsychotic drugs. Compared with placebo-treated patients, more patients treated with antipsychotic drugs had movement disorders, gained weight, and experienced sedation. There was considerable heterogeneity in the effect size. There was no correlation between the number of episodes, first-generation or second-generation drugs, and allocation concealment method with relapse risk. Relapse rate was reduced more with depot preparations (RR, 0.31) than oral drugs (RR, 0.46), with depot haloperidol and fluphenazine having the greatest effects (RR, 0.14 and 0.23, respectively).

"Maintenance treatment with antipsychotic drugs benefits patients with schizophrenia. The advantages of these drugs must be weighed against their side-effects," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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