Olanzapine and risperidone.
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Antipsychotic Agents↗
Biomedical subjects
Raymond C Love
Publications and source records attributed to Raymond C Love.
Rehospitalization risk with second-generation and depot antipsychotics.
Decreasing hospital admissions is important for improving outcomes for people with schizophrenia. Second-generation antipsychotics (SGAs) are better tolerated for long-term therapy than traditional medications and may contribute to a lower rehospitalization risk, but have not been compared to depot forms with regard to long-term outcomes. This study evaluates the risk of readmission in patients discharged from six State of Maryland inpatient mental health facilities between Jan. 1, 1997 and Dec. 31, 1997 on clozapine (N = 41), risperidone (N = 149), and olanzapine (N = 103). These patients were compared with those discharged from the two largest state facilities during the same time period on fluphenazine decanoate (N = 59) or haloperidol decanoate (N = 59). One-year readmission risk (measured by Kaplan-Meier survival analysis with Holm's adjustment for multiple comparison on Log Rank tests) were 10% for clozapine, 12% for risperidone, and 13% for olanzapine. These risks were not significantly lower than the readmission risk for fluphenazine decanoate (21%) but were significantly lower than haloperidol decanoate (35%) for all three SGAs. Demographic and clinical variables did not predict readmission for any of the medications. In patients with similar demographic and clinical characteristics, 1-year risk of readmission for patients treated with SGAs were at least comparable to the 1-year risk for patients receiving fluphenazine decanoate and lower than the risk for patients treated with haloperidol decanoate. SGAs may provide better long-term prognoses and outcomes for patients with schizophrenia.
Adult↗
Strategies for increasing treatment compliance: the role of long-acting antipsychotics.
Increased patient compliance with antipsychotic medications is associated with increased efficacy and reduced rates of rehospitalization. It can improve treatment outcomes for patients and reduce costs for society. An understanding of the reasons for noncompliance is essential in formulating strategies to provide better health and economic outcomes. Time-tested strategies such as addressing adverse effects, educating patients, and forming patient-provider alliances with those receiving medications can have a dramatic impact on compliance. Depot antipsychotics have been the mainstay of treatment for patients with schizophrenia who are known to be noncompliant. These agents are especially effective when combined with social support. Atypical antipsychotics, with their improved efficacy and tolerability, appear to increase compliance and reduce rehospitalization compared with conventional oral and depot agents. A new long-acting formulation of an atypical antipsychotic agent combines the advantages of depot drugs and atypical agents. However, such a drug also poses challenges in the changing setting of community mental health. These challenges present pharmacists with an opportunity to assume new roles in the management of patients requiring antipsychotic therapy.
Antipsychotic Agents↗
Novel factor-based symptom scores in treatment resistant schizophrenia: implications for clinical trials.
To study the factor structure of symptoms in patients with treatment resistant schizophrenia and whether it is altered by treatment, we analyzed ratings on the Brief Psychiatric Rating Scale (BPRS) from two independent groups of patients with treatment resistant schizophrenia. With confirmatory factor analysis of pre-clozapine BPRS scores in 1074 patients in an administrative data base, the Clozapine Authorization and Monitoring Program (CAMP), we assessed the fit of published factor models and developed a better-fitting model. Model fit was validated in an independent group of 197 research unit participants. Stability of model fit six months post-clozapine was assessed in 834 CAMP patients. A new 4-factor model (negative symptoms, reality distortion, disorganization, and anxiety/depression) had better fit in both data sets than two commonly used factor models, and also fit better post-clozapine. We recommend these four factor scores as clinical trial outcomes in patients with treatment resistant schizophrenia.
Adolescent↗