Onset of action of atypical and typical antipsychotics in the treatment of acute psychosis
- PMID: 24991622
- PMCID: PMC4076925
- DOI: 10.4103/2279-042X.128142
Onset of action of atypical and typical antipsychotics in the treatment of acute psychosis
Abstract
Objective: Antipsychotic medications are the frontline treatment for the most psychotic disorders. The aim of this study is to compare the onset of action of the first and second generation antipsychotics and the rate of their side-effects in the treatment of acute psychosis.
Methods: In a double-blind, controlled clinical trial, 40 acute psychotic patients were randomly allocated in four groups and treated with each of the four antipsychotics: olanzapine, risperidone, haloperidol or thiothixene. The onset of action of each drug was assessed by the Positive and Negative Symptoms Scale. The data were analyzed by Wilcoxon (Gehan) survival and Log Rank analysis, using SPSS version 20.0.
Findings: Initial response was observed in 97.5% (N = 39) of subjects during 2 weeks of intervention. The mean time to the first response was 6.15 ± 2.9 days and this was significantly shorter for risperidone than others. The most common side-effects were sedation and drug induced Parkinsonism.
Conclusion: Risperidone represented shorter onset of action for the treatment of acute psychotic symptoms compared with olanzapine, haloperidol and thiothixene.
Keywords: Acute psychosis; antipsychotic; onset of action; response; side effect.
Conflict of interest statement
Figures
Similar articles
-
[Antipsychotics in bipolar disorders].Encephale. 2004 Sep-Oct;30(5):417-24. doi: 10.1016/s0013-7006(04)95456-5. Encephale. 2004. PMID: 15627046 Review. French.
-
Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trial of olanzapine versus haloperidol.Am J Psychiatry. 2003 Aug;160(8):1396-404. doi: 10.1176/appi.ajp.160.8.1396. Am J Psychiatry. 2003. PMID: 12900300 Clinical Trial.
-
Letter to the Editor: Rethinking The Cost Of Antipsychotic Treatment: The Average Cost Of The Drugs Used In Turkey In 2020.Turk Psikiyatri Derg. 2022 Summer;33(2):146-148. doi: 10.5080/u26315. Turk Psikiyatri Derg. 2022. PMID: 35730516 English, Turkish.
-
Double-blind comparison of first- and second-generation antipsychotics in early-onset schizophrenia and schizo-affective disorder: findings from the treatment of early-onset schizophrenia spectrum disorders (TEOSS) study.Am J Psychiatry. 2008 Nov;165(11):1420-31. doi: 10.1176/appi.ajp.2008.08050756. Epub 2008 Sep 15. Am J Psychiatry. 2008. PMID: 18794207 Clinical Trial.
-
[Cost-effectiveness analysis of schizophrenic patient care settings: impact of an atypical antipsychotic under long-acting injection formulation].Encephale. 2005 Mar-Apr;31(2):235-46. doi: 10.1016/s0013-7006(05)82390-5. Encephale. 2005. PMID: 15959450 Review. French.
Cited by
-
Efficacy and Tolerability of Adjunctive Intravenous Sodium Nitroprusside Treatment for Outpatients With Schizophrenia: A Randomized Clinical Trial.JAMA Psychiatry. 2019 Jul 1;76(7):691-699. doi: 10.1001/jamapsychiatry.2019.0151. JAMA Psychiatry. 2019. PMID: 30916714 Free PMC article. Clinical Trial.
-
A case report of guardian-consent forced paliperidone palmitate for behavioral disturbance due to traumatic brain injury.Ment Health Clin. 2018 Apr 26;8(3):155-158. doi: 10.9740/mhc.2018.05.155. eCollection 2018 May. Ment Health Clin. 2018. PMID: 29955561 Free PMC article.
-
Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug.Diagnostics (Basel). 2022 Mar 25;12(4):803. doi: 10.3390/diagnostics12040803. Diagnostics (Basel). 2022. PMID: 35453850 Free PMC article.
-
Haloperidol (oral) versus olanzapine (oral) for people with schizophrenia and schizophrenia-spectrum disorders.Cochrane Database Syst Rev. 2024 Jul 3;7(7):CD013425. doi: 10.1002/14651858.CD013425.pub2. Cochrane Database Syst Rev. 2024. PMID: 38958149 Free PMC article.
References
-
- Lewis S, Escalona PR, Keith SJ. Phenomenology of Schizophrenia. In: Sadock BJ, Sadock VA, Ruiz P, editors. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. 9th ed. New York: Lippincott Williams and Wilkins; 2009. pp. 1433–51.
-
- Lieberman JA, Fenton WS. Delayed detection of psychosis: Causes, consequences, and effect on public health. Am J Psychiatry. 2000;157:1727–30. - PubMed
-
- Fenton WS, Blyler CR, Heinssen RK. Determinants of medication compliance in schizophrenia: Empirical and clinical findings. Schizophr Bull. 1997;23:637–51. - PubMed
-
- Malla A, Norman R, Schmitz N, Manchanda R, Béchard-Evans L, Takhar J, et al. Predictors of rate and time to remission in first-episode psychosis: A two-year outcome study. Psychol Med. 2006;36:649–58. - PubMed
-
- Lieberman JA, Tollefson GD, Charles C, Zipursky R, Sharma T, Kahn RS, et al. Antipsychotic drug effects on brain morphology in first-episode psychosis. Arch Gen Psychiatry. 2005;62:361–70. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources