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117 Impact of Antipsychotic Treatment Switching in Patients with Schizophrenia, Bipolar Disorder, and Major Depressive Disorder
CNS Spectrums ( IF 3.3 ) Pub Date : 2020-04-24 , DOI: 10.1017/s1092852920000358
Rajeev Ayyagari , Darren Thomason , Fan Mu , Michael Philbin , Benjamin Carroll

:Study Objective:To evaluate the risk of relapse for patients with schizophrenia (SZ), bipolar disorder (BP), and major depressive disorder (MDD) who switched antipsychotics compared with those who did not switch.Background:Antipsychotics are commonly used for maintenance treatment of SZ, BP, and MDD but can have significant side effects, such as extrapyramidal symptoms (EPS). Adherence to treatment is important for reducing the risk of relapse, but fear of side effects may prompt medication switching.Methods:Medicaid claims from 6 US states spanning 6 years were retrospectively analyzed for antipsychotic switching versus non-switching. For all patients with SZ, BD or MDD and for the subset of patients who also had ≥1 EPS diagnosis during the baseline period, times to the following outcomes, during a 2-year study period were analyzed: underlying disease relapse, psychiatric relapse, all-cause emergency room (ER) visit, all-cause inpatient (IP) admission and EPS diagnosis.Results:Switchers (N=10,548) had a shorter time to disease relapse, other psychiatric relapse, IP admissions, ER visits, and EPS diagnosis (all, log-rank P<0.001) than non-switchers (N=31,644). Switchers reached the median for IP admission (21.50 months) vs non-switchers (not reached) and for ER visits (switchers, 9.07 months; non-switchers, 13.35 months). For disease relapse, other psychiatric relapse, and EPS diagnosis, <50% of patients had an event during the 2-year study period. Comparisons in a subgroup of patients with ≥1 EPS diagnosis revealed similar outcomes.Conclusions:These results show that disease and other psychiatric relapse, all-cause ER visits, IP admissions, and EPS diagnosis occurred earlier for switchers than for non-switchers, suggesting that switching is associated with an increased risk of relapse in patients with SZ, BP and MDD.Funding Acknowledgements:This study was supported by Teva Pharmaceuticals, Petach Tikva, Israel.

中文翻译:

117 抗精神病药物治疗转换对精神分裂症、双相情感障碍和重度抑郁症患者的影响

: 研究目的: 评估精神分裂症 (SZ)、双相情感障碍 (BP) 和重度抑郁症 (MDD) 患者更换抗精神病药物与未更换抗精神病药物的患者相比的复发风险。背景:抗精神病药物常用于维持治疗治疗 SZ、BP 和 MDD,但可能有明显的副作用,例如锥体外系症状 (EPS)。坚持治疗对于降低复发风险很重要,但对副作用的恐惧可能会促使药物转换。方法:回顾性分析来自美国 6 个州 6 年的医疗补助索赔,以分析抗精神病药物转换与非转换的情况。对于所有患有 SZ、BD 或 MDD 的患者以及在基线期间也有 ≥1 次 EPS 诊断的患者子集,在 2 年的研究期间分析了以下结果的时间:潜在疾病复发、精神疾病复发、全因急诊 (ER) 就诊、全因住院 (IP) 入院和 EPS 诊断。结果:切换者 (N=10,548) 到疾病复发、其他精神疾病复发、IP 的时间较短入院、急诊就诊和 EPS 诊断(所有,log-rank P<0.001)比非转换者(N=31,644)。转换者达到 IP 入院(21.50 个月)与非转换者(未达到)和急诊室就诊(转换者,9.07 个月;非转换者,13.35 个月)的中位数。对于疾病复发、其他精神疾病复发和 EPS 诊断,<50% 的患者在 2 年研究期间发生事件。对 ≥ 1 次 EPS 诊断的患者亚组进行比较,结果相似。结论:这些结果表明,疾病和其他精神疾病复发、全因急诊就诊、IP 入院、
更新日期:2020-04-24
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