@article{10902/16085,
year = {2018},
url = {http://hdl.handle.net/10902/16085},
abstract = {BACKGROUND:
Different effectiveness profiles among second-generation antipsychotics may be a key point to optimize treatment in patients suffering a first episode of psychosis to affect long-term outcome. The aim of this study was to compare the clinical effectiveness of aripiprazole, ziprasidone, and quetiapine in the treatment of first episode of psychosis at 3-year follow-up.

METHOD:
From October 2005 to January 2011, a prospective, randomized, open-label study was undertaken. Two hundred-two first-episode, drug-naïve patients were randomly assigned to aripiprazole (n=78), ziprasidone (n =62), or quetiapine (n=62) and followed-up for 3 years. The primary effectiveness measure was all cause of treatment discontinuation. In addition, an analysis based on the intention-to-treat principle was conducted in the analysis for clinical efficacy.

RESULTS:
The overall dropout rate at 3 years reached 19.3%. Treatment discontinuation rates were significantly different among treatment groups (aripiprazole=73.08%, ziprasidone=79.03%, and quetiapine=95.16%) (?2=11.680; P=.001). Statistically significant differences in terms of nonefficacy, nonadherence, and side effects were observed among treatment groups along the 3-year follow-up determining significant differences in time to all-cause discontinuation (log-rank=32.260; P=.001). Significant differences between treatments were found in the categories of sleepiness/sedation (?2=9.617; P=.008) and increased sleep duration (?2=6.192; P=.004). No significant differences were found in the profile of extrapyramidal symptoms. Patients on aripiprazole were more likely to be prescribed benzodiazepines.

CONCLUSIONS:
First-episode psychosis patients on quetiapine were more likely to discontinue treatment due to nonefficacy. Identifying different discontinuation patterns may contribute to optimize treatment selection after first episode of psychosis.},
organization = {This work was supported by Plan Nacional de Drogas Research (2005-Orden sco/3246/2004); SENY Fundacio (CI 2005–0308007); Fundacion Marques de Valdecilla (API07/011); and Gerencia Regional de Salud de Castilla y Leon (INT/M/04/17). The study was carried out at the Hospital Marques de Valdecilla, University of Cantabria, Santander, Spain. Unrestricted educational and research grants from AstraZeneca, Pfizer, Bristol-Myers Squibb, and Johnson & Johnson provided support for PAFIP activities. No pharmaceutical industry or institutional sponsors participated in the study design, data collection, analysis, or interpretation of the results.},
publisher = {Oxford University Press},
publisher = {Int J Neuropsychopharmacol. 2018 Dec 1;21(12):1090-1101},
title = {Long-Term Antipsychotic Effectiveness in First Episode of Psychosis: A 3-Year Follow-Up Randomized Clinical Trial Comparing Aripiprazole, Quetiapine, and Ziprasidone},
author = {Gómez Revuelta, Marcos and Pelayo Terán, José María and Juncal Ruiz, María and Ortiz-García de la Foz, Víctor and Vázquez Bourgon, Javier and González-Pinto, Ana and Crespo Facorro, Benedicto},
}