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Are We Treating Schizophrenia Effectively? Understanding the Primary Outcomes of the CATIE Study

Published online by Cambridge University Press:  07 November 2014

William M. Glazer ,
Robert R. Conley  and
Leslie Citrome
William M. Glazer
Affiliation:
Dr. Glazer is president of Glazer Medical Solutions in Menemsha, Massachusetts. He is a consultant to Eli Lilly; and is on the advisory boards of AstraZeneca, Eli Lilly, and Pfizer.
Robert R. Conley
Affiliation:
Dr. Conley is professor of psychiatry and pharmacy science at, the University of Maryland in Baltimore, chief of the Treatment Research Program at the Maryland Psychiatric Research Center, and chair of the Institutional Review Board at the National Institute on Drug Abuse. He is a consultant to AstraZeneca, Eli Lilly, Janssen, and Organon; and is on the advisory boards of Eli Lilly and Johnson & Johnson.
Leslie Citrome
Affiliation:
Dr. Citrome is professor of psychiatry at, the New York University School of Medicineand director of the Clinical Research and Evaluation Facility at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York. He is a consultant to Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, and Pfizer; on the advisory boards of Eli Lilly and GlaxoSmithKline; on the speaker's bureaus of Abbott, AstraZeneca, Eli Lilly, and Pfizer; and receives grant/research support from AstraZeneca, Barr, Bristol-Myers Squibb, Eli Lilly, Janssen, and Pfizer.
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Abstract

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study for schizophrenia was designed to independently evaluate the effectiveness of antipsychotic treatment in “real-world” patients. To assess the effectiveness of the conventional antipsychotics compared to the atypicals as well as the differences among the atypicals, patients were randomized to one of four atypical antipsychotics (olanzapine, quetiapine, risperidone, ziprasidone) or a representative conventional antipsychotic (perphenazine). Effectiveness was defined by time to discontinuation and duration of successful treatment. Time to “all-cause” discontinuation reflects both efficacy (ability of a drug to reduce symptoms) and safety/tolerability. Phase I revealed discontinuation rates ranging from 64% for olanzapine to 82% for quetiapine.

Differences among the medications may be important in the selection of a drug for a particular patient. Physicians should involve the patient in choosing their medication by inquiring about the patient's past experience with medications and side effects, educating the patient on the risk-benefit ratio, and considering the patient's preference. To demonstrate how results of the CATIE study can contribute to the knowledge of practicing clinicians, this monograph presents a representative clinical case patient and illustrates how the CATIE safety and efficacy data has important implications for the patient.

Type
Research Article
Information
CNS Spectrums , Volume 11 , Issue S10 , 2006 , pp. 1 - 16
Copyright
Copyright © Cambridge University Press 2006

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