Relapse prevention and remission attainment in first-episode non-affective psychosis. A randomized, controlled 1-year follow-up comparison of haloperidol, risperidone and olanzapine

Nov 26, 2010Journal of psychiatric research

Preventing relapse and achieving remission in first-time non-affective psychosis: one-year comparison of haloperidol, risperidone, and olanzapine

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Abstract

Relapse rates during the first year of treatment were 11.1% for haloperidol, 18.5% for olanzapine, and 13.8% for risperidone.

No significant differences were observed in relapse rates between haloperidol and the second-generation antipsychotics (SGAs).
Time until relapse did not differ among the treatment groups.
Adherent patients experienced a significantly lower relapse rate (11.2%) compared to non-adherent patients (26.9%).
Remission rates did not show significant differences across the three treatment groups.
Adherence to medication did not significantly influence remission rates.

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The effectiveness of antipsychotics in preventing relapses and attaining symptomatic remission is a relevant topic of psychopharmacological research. The purpose of the present study was to compare the relapse and symptomatic remission rates during the first year of treatment between low doses of haloperidol and SGAs (olanzapine and risperidone) in drug-naïve first-episode non-affective psychosis individuals. This is a prospective, randomized, open-label study conducted from February 2001 to February 2006. Data for the present investigation were obtained from a large epidemiologic and 3-year longitudinal intervention program of first-episode psychosis (DSM-IV criteria) conducted at the University Hospital Marques de Valdecilla, Santander, Spain. One hundred and seventy four patients were randomly assigned to haloperidol (N = 56), olanzapine (N = 55), or risperidone (N = 63) and followed up for 1 year. Primary effectiveness measures were the time up to relapse and rates of relapse and symptomatic remission. There were no significant differences in the relapse rate between treatments (11.1% haloperidol; 18.5% olanzapine, and 13.8% risperidone) (χ(2) = 1.230; p = 0.541) or in the time up to relapse (Log Rank χ(2) = 0.308; p = 0.857). The rates of relapse for adherent (11.2%) and non-adherent (26.9%) patients were significantly different (χ(2) = 4.215; df = 1; p = 0.040). The remission rate did not differ significantly between treatment groups (χ(2) = 2.760; p = 0.252) and adherence to medication did not seem to significantly influence remission rates. We conclude that haloperidol, olanzapine and risperidone show a similar effectiveness in relapse prevention or in remission attainment during the first year of treatment.

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Relapse prevention and remission attainment in first-episode non-affective psychosis. A randomized, controlled 1-year follow-up comparison of haloperidol, risperidone and olanzapine

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