TY - JOUR
T1 - Optimizing subjective wellbeing with amisulpride in first episode schizophrenia or related disorders
AU - de Haan, Lieuwe
AU - van Tricht, Mirjam
AU - van Dijk, Floor
AU - Arango, Celso
AU - Díaz-Caneja, Covadonga M.
AU - Bobes, Julio
AU - García-Álvarez, Leticia
AU - Leucht, Stefan
N1 - Funding Information: The OPTiMiSE trial was funded by the European Commission within the 7th Program (HEALTH-F2-2010-242114). Publisher Copyright: Copyright © The Author(s), 2022. Published by Cambridge University Press.
PY - 2023/10/15
Y1 - 2023/10/15
N2 - Background Subjective response (SR) to antipsychotic medication is relevant for quality of life, adherence and recovery. Here, we evaluate (1) the extent of variation in SR in patients using a single antipsychotic; (2) the association between subjective and symptomatic response; and (3) predictors of SR. Methods Open-label, single treatment condition with amisulpride in 339 patients with a first episode of a schizophrenia spectrum disorder, at most minimally treated before inclusion. Patients were evaluated at baseline, before start with amisulpride and after four weeks of treatment with the Subjective Wellbeing under Neuroleptic scale, the Positive and Negative Syndrome Scale, and the Calgary Depression Scale for Schizophrenia. Results (1) 26.8% of the patients had a substantial favorable SR, and 12.4% of the patients experienced a substantial dysphoric SR during treatment with amisulpride. (2) Modest positive associations were found between SR and 4 weeks change on symptom subscales (r = 0.268-0.390, p values < 0.001). (3) Baseline affective symptoms contributed to the prediction of subjective remission, demographic characteristics did not. Lower start dosage of amisulpride was associated with a more favorable SR (r = -0.215, p < 0.001). Conclusions We conclude that variation in individual proneness for an unfavorable SR is substantial and only modestly associated with symptomatic response. We need earlier identification of those most at risk for unfavorable SR and research into interventions to improve SR to antipsychotic medication in those at risk.
AB - Background Subjective response (SR) to antipsychotic medication is relevant for quality of life, adherence and recovery. Here, we evaluate (1) the extent of variation in SR in patients using a single antipsychotic; (2) the association between subjective and symptomatic response; and (3) predictors of SR. Methods Open-label, single treatment condition with amisulpride in 339 patients with a first episode of a schizophrenia spectrum disorder, at most minimally treated before inclusion. Patients were evaluated at baseline, before start with amisulpride and after four weeks of treatment with the Subjective Wellbeing under Neuroleptic scale, the Positive and Negative Syndrome Scale, and the Calgary Depression Scale for Schizophrenia. Results (1) 26.8% of the patients had a substantial favorable SR, and 12.4% of the patients experienced a substantial dysphoric SR during treatment with amisulpride. (2) Modest positive associations were found between SR and 4 weeks change on symptom subscales (r = 0.268-0.390, p values < 0.001). (3) Baseline affective symptoms contributed to the prediction of subjective remission, demographic characteristics did not. Lower start dosage of amisulpride was associated with a more favorable SR (r = -0.215, p < 0.001). Conclusions We conclude that variation in individual proneness for an unfavorable SR is substantial and only modestly associated with symptomatic response. We need earlier identification of those most at risk for unfavorable SR and research into interventions to improve SR to antipsychotic medication in those at risk.
KW - amisulpiride
KW - antipsychotic
KW - response
KW - schizophrenia
KW - subjective wellbeing
UR - http://www.scopus.com/inward/record.url?scp=85172425638&partnerID=8YFLogxK
U2 - https://doi.org/10.1017/S0033291722003142
DO - https://doi.org/10.1017/S0033291722003142
M3 - Article
C2 - 36520136
SN - 0033-2917
VL - 53
SP - 5986
EP - 5991
JO - Psychological Medicine
JF - Psychological Medicine
IS - 13
ER -