Selection of Antipsychotic Agents in a Psychiatric Hospital Based on Results of CATIE Study

Gutiérrez-Suela, Felicitas

doi:10.1016/S2173-5085(08)70031-5

Farmacia Hospitalaria

ISSN: 1130-6343

Farmacia Hospitalaria (Farm Hosp) is the official publication of the Spanish Society of Hospital Pharmacists (SEFH), a professional and scientific organization that currently has about 4.351 members.

The Mission of Farm Hosp is to be the support for health professionals for expanding the influence of projects, publications, and training programs, and to promote the exchange of experiences.

Vision Farm Hosp is:
- to increase the state of knowledge about the hospital pharmacy and whose actions should increase the adequate and safe use of medicines and health products.
- to be an instrument of exchange and dissemination of scientific knowledge of pharmacy practice through the best use and safe medication and health outcomes.

It is a peer-reviewed double-blind scientific journal aimed at publishing in the broad field of Hospital Pharmacy advances in Pharmacy Services. This journal included the following topics: Drug evaluation. Quality of life. Patient Reported Outcome Measures (PROMs), and Patient Reported Experience Measures (PREMs) in the use of drugs. Monitoring medication. Pharmaceutical compounding. Medication administration. Management of Pharmacy Services (logistics, quality control). Technologies and information systems in the process of using medication. Medical devices. Patient Education. Pharmacist´s role in the society and /or in the Health System in Spain, and other topics related to clinical, scientific, and institutional role of hospital pharmacists.

Farmacia Hospitalaria publishes bimonthly (6 issues yearly) originals, short originals, reviews, clinical cases, special articles, protocols, consensus documents, clinical guidelines, letters to the editor, editorials.

All the articles are published in Spanish and English language regardless of the language in which they are received.

Farmacia Hospitalaria is an Open Access journal, whose content is available free of charge to users or their institutions. Users are authorised to read, download, copy, distribute, print, search, or link to entire texts of the articles in this journal without prior permission from the editor or author, according to the BOAI definition of Open Access. The papers may be re-used under the terms of the Creative Commons 4.0 license. (CC BY-NC-ND). Such use shall be subject to authorisation from SEFH, the journal owner.

Farmacia Hospitalaria journal charges no fees for submission of papers or publication of articles.

Adherence to international ethics recommendations

Manuscripts must follow the most recent recommendations of the International Committee of Medical Journal Editors (available at http://www.icmje.org).

The articles published in Farmacia Hospitalaria are indexed in PubMed and other 17 date bases:
- Evaluation databases: MEDLINE, DOAJ, Scopus, Latindex y Scimago Journal and Country Rank (SJR). Índice H: 18, quartile 3 (Medicine, miscellaneous / Pharmacology)
- Bibliographic databases: CINHAL, EMBASE Excerpta Medica, Índice Bibliográfico Español en Ciencias de la Salud (IBECS), Índice Español de Ciencia Y Tecnología (ICyT), Índice Médico Español (IME), International Pharmaceutical Abstracts (IPA).
- Journal collections: Dialnet, Medes, Scientific Electronic Library Online (SciELO), REDIB, ScienceDirect, ClinicalKey.

Indexed in:

Medline, Emerging Sources Citation Index (ESCI), Directory of Open Access Journals (DOAJ)

A standard method was used; this method considers 4 main evaluation criteria and 4 secondary criteria. The typical antipsychotic drug, perphenazine, was compared with the atypical antipsychotic drugs (olanzapine, quetiapine, risperidone, and ziprasidone). The measures of efficacy of the most important criteria come from the clinical trial “Clinical Antipsychotic Trials for Intervention Effectiveness” (CATIE).

Results

The scores of the different antipsychotic drugs were as follows: perphenazine, 59.68; olanzapine, 52.98; risperidone, 51.53; ziprasidone, 46.42; and quetiapine, 45.41. Olanzapine was equal to perphenazine when the cost criteria was reduced by 72.97%.

Conclusions

The typical antipsychotic drug perphenazine is the drug receiving the best assessment for the treatment of schizophrenia. Olanzapine is an alternative if its cost is reduced.

Key words:

Atypical antipsychotic drug

Typical antipsychotic drug

Cost-efficacy

CATIE study

Selection of antipsychotic drugs

Resumen

Objetivo

Seleccionar antipsicóticos, clásico versus atípico, para su uso como tratamiento de elección en el paciente esquizofrénico de un hospital psiquiátrico.

Método

: Se utiliza un método normalizado que tiene en cuenta cuatro criterios principales de valoración y cuatro secundarios. Se compara el antipsicótico clásico perfenazina con los atípicos olanzapina, quetiapina, risperidona y ziprasidona. Las medidas de efectividad de los criterios más importantes proceden del ensayo clínico “Ensayos clínicos de intervención sobre la efectividad de los antipsicóticos” (CATIE; Clinical Antipsychotic Trials for Intervention Effectiveness).

Resultados

Las puntuaciones de los distintos antipsicóticos fueron las siguientes: perfenazina, 59,68; olanzapina, 52,98; risperidona, 51,53; ziprasidona, 46,42, y quetiapina, 45,41. La olanzapina iguala a la perfenazina cuando se reduce la medida del criterio coste un 72,97%.

Conclusiones

El antipsicótico clásico perfenazina es el medicamento mejor valorado para el tratamiento de la esquizofrenia. La olanzapina es una alternativa si se reduce su coste.

Palabras clave:

Antipsicótico atípico

Antipsicótico clásico

Coste-efectividad

Estudio CATIE

Selección de antipsicóticos

Full text is only available in PDF

References

[1.]

Segú Tolsa JL. Elementos para la gestión del medicamento en los sistemas de salud: la visión de la microgestión. Módulo 5. Unidad Didáctica 1. Máster en Economía de la Salud y del Medicamento. Universidad Pompeu Fabra. Barcelona; 2005–2007.

[2.]

Memoria económica. Servicio de Farmacia. Sagrat Cor, Serveis de Salut Mental. Martorell; 2006.

[3.]

Catálogo de Medicamentos. Consejo General de Colegios Oficiales de Farmacéuticos: Madrid; 2006.

[4.]

Gasto en medicamentos e innovación terapéutica. Butll Groc. 2004;17: 13-8.

[5.]

S. Miyamoto, G.E. Duncan, C.E. Marx, J.A. Lieberman.

Treatment for schizophrenia: a critical review of pharmacology and mechanisms of action of antipsychotic drugs.

Mol Psychiatry, 10 (2005), pp. 79-104

http://dx.doi.org/10.1038/sj.mp.4001556 | Medline

[6.]

R. Rosenheck, D. Perlick, S. Binghan, W. Liu-Mares, J. Collins, S. Warren, et al.

Effectiveness and cost of olanzapine and haloperidol in the treatment of schizophrenia: a randomized controlled trial.

JAMA, 290 (2003), pp. 2693-2702

[7.]

G.D. Tollefson, T.M. Sanger.

Negative symptoms: a path analytic approach to a double-blind, placebo-and haloperidol-controlled clinical trial with olanzapine.

Am J Psychiatry, 154 (1997), pp. 466-474

http://dx.doi.org/10.1176/ajp.154.4.466 | Medline

[8.]

S. Leucht, K. Walhlbeck, J. Haman, W. Kissling.

New generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis.

Lancet, 361 (2003), pp. 1581-1589

http://dx.doi.org/10.1016/S0140-6736(03)13306-5 | Medline

[9.]

J.M. Davis, N. Chen, I.D. Glick.

A meta-analysis of the efficacy of secondgeneration antipsychotics.

Arch Gen Psychiatry, 60 (2003), pp. 553-564

http://dx.doi.org/10.1001/archpsyc.60.6.553 | Medline

[10.]

J. Halliday, S. Farrington, S. McDonald, T. McEvan, V. Sharkey, R. McCreadie.

Nithsdale schizophrenia surveys 23: movement disorders, 20 year review.

Br J Psychiatry, 181 (2002), pp. 422-427

Medline

[11.]

P.A. Rochon, T.A. Stukel, K. Sykora, S. Gill, S. Garfinkel, G.M. Anderson, et al.

Atypical antipsychotics and parkinsonism.

Arch Intern Med, 165 (2005), pp. 1822-1888

[12.]

H.A. Nasrallah, J.W. Newcomer.

Atypical antipsychotics and metabolic dysregulation. Evaluation the risk/benefit equation and improving the standard of care.

J Clin Psychopharmacol, 24 (2004), pp. S7-S14

Medline

[13.]

J.A. Lieberman, T.S. Stroup, J. McEvoy, M.S. Swartz, R.A. Rosenheck, D.O. Perkins, et al.

Effectiveness of antipsychotic drugs in patients with chronic schizophrenia.

N Engl J Med, 353 (2005), pp. 1209-1223

[14.]

Ordovás JP, Climente M, Poveda JL. Selección de medicamentos y guía farmacoterapéutica. Available from: http://sefh.interguias.com/libros/Tomo1_Cap1-3-1-1.pdf

[15.]

M.J. Martínez-Bengoechea, A. Viniegra, C. Saiz de Rozas, A. Arana, O. Ibarra, M.G. García.

Criterios de selección de medicamentos para su inclusión en una guía farmacoterapéutica. Elección y ponderación.

Farm Hosp, 20 (1996), pp. 60-65

[16.]

T.S. Stroup, J.A. Lieberman, J. McEvoy, M.S. Swartz, S.M. Davis, R.A. Rosenheck, et al.

Efectiveness of olanzapine, quetiapine, risperidone and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic.

Am J Psychiatry, 163 (2006), pp. 611-622

http://dx.doi.org/10.1176/appi.ajp.163.4.611 | Medline

[17.]

J. McEvoy, J. Lieberman, T.S. Stroup, S.M. Davis, H.Y. Meltzer, R.A. Rosenheck, et al.

Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment.

Am J Psychiatry, 163 (2006), pp. 600-610

http://dx.doi.org/10.1176/appi.ajp.163.4.600 | Medline

[18.]

R. Rosenheck, D. Leslie, J. Sindelar, E.A. Miller, H. Lin, T.S. Stroup, et al.

Cost-effectiveness of second-generation antipsychotics and perphenazine in a randomized trial of treatment for chronic schizophrenia.

Am J Psychiatry, 163 (2006), pp. 2080-2089

http://dx.doi.org/10.1176/ajp.2006.163.12.2080 | Medline

[19.]

Departamentos Técnicos de los laboratorios farmacéuticos Astra Zeneca Janssen, Lilly, Merck Farma y Química y Pfizer. Barcelona; 2007.

[20.]

M. Salazar, C. Peralta, J. Pastor.

Tratado de psicofarmacología. Bases y aplicación clínica.

Médica Panamericana, (2005),

[21.]

The Royal Pharmaceutical Society of Great Britain. Martindale: The complete drug reference. London; 2005.

[22.]

Stockley,

[23.]

Richard B editor. The Medical Letter on Drugs and Therapeutics: Compendio de interacciones adversas de medicamentos. Barcelona; 2002.

[24.]

M.J. Martínez-Bengoechea, J.C. Ibánez-Carranza, M.J. Arrizabalaga.

Computer program for pharmacy and therapeutics Commites’drug evaluations.

PWS, 18 (1996), pp. A25

[25.]

R. Freedman, W.T. Carpenter, J.M. Davis, H.H. Goldman, C.A. Tamminga, M. Thomas.

The cost of drugs for schizophrenia.

Am J Psychiatry, 163 (2006), pp. 2029-2031

http://dx.doi.org/10.1176/ajp.2006.163.12.2029 | Medline

[26.]

V. Peralta.

Ensayos clínicos, industria farmacéutica y práctica clínica.

Bol Inf Ter de Navarra, 13 (2005), pp. 29-34

[27.]

J.M. Davis, N. Chen.

Dose response and dose equivalence of antipsychotics.

J Clin Psychopharmacol, 24 (2004), pp. 192-208

Medline

[28.]

D. Polsky, J.A. Doshi, M.S. Bauer, H. Glick.

Clinical trial-based costeffectiveness analyses of antipsychotic use.

Am J Psychiatry, 163 (2006), pp. 2047-2056

http://dx.doi.org/10.1176/appi.ajp.163.12.2047 | Medline

[29.]

Trastornos psicóticos,

[30.]

P.B. Jones, T. Barnes, L. Davies, G. Dunn, H. Lloyd, K.P. Hayhurst, et al.

Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia. Cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1).

Arch Gen Psychiatry, 63 (2006), pp. 1079-1087

http://dx.doi.org/10.1001/archpsyc.63.10.1079 | Medline

[31.]

Mata I, Beperet M, Madoz V y grupo Psicost. Nuevas perspectivas en la psicopatología de los trastornos esquizofrénicos. Anales del Sistema Sanitario de Navarra. 23(1). Available from: http://www.cfnavarra.es/salud/anales/tex-tos/vol23/suple1/suple3ª.html.

[32.]

Anónimo.

Retiradas recientes de medicamentos.

Butll Groc, 12 (1999), pp. 5-8

[33.]

Sertindol vuelve al mercado español tras probar su seguridad cardiovascular. Available from: http://www.correofarmaceutico.com/rec-templating/templates/co-rreo_farmaceutico/cmp/view Document_CF.jsp

[34.]

S. Leucht, G. Pitschel-Walz, R. Engel, W. Kissling.

Amisulpride, an usual “atypical” antipsychotic: a meta-analysis of randomized controlled trials.

Am J Psyciatry, 159 (2002), pp. 180-190

[35.]

Calderón P, Gutiérrez JR, Velasco JJ. Psiquiatría. Available from: http://sefh.interguias.com/libros/Tomo2_Cap18.pdf

Tools

Indexed in:

Follow us:

Subscribe to our newsletter