Optimizing subjective wellbeing with amisulpride in first episode schizophrenia or related disorders.

de Haan, Lieuwe; van Tricht, Mirjam; van Dijk, Floor; Arango, Celso; Díaz-Caneja, Covadonga M; Bobes, Julio; García-Álvarez, Leticia; Leucht, Stefan

doi:10.1017/S0033291722003142

2023

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Title:: Optimizing subjective wellbeing with amisulpride in first episode schizophrenia or related disorders.
Document type:: Article; Journal Article
Author(s):: de Haan, Lieuwe; van Tricht, Mirjam; van Dijk, Floor; Arango, Celso; Díaz-Caneja, Covadonga M; Bobes, Julio; García-Álvarez, Leticia; Leucht, Stefan
Abstract:: 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.
Journal title abbreviation:: Psychol Med
Year:: 2023
Journal volume:: 53
Journal issue:: 13
Pages contribution:: 5986-5991
Fulltext / DOI:: doi:10.1017/S0033291722003142
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/36520136
Print-ISSN:: 0033-2917
TUM Institution:: Klinik und Poliklinik für Psychiatrie und Psychotherapie (Prof. Priller)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Psychiatrie und Psychotherapie (Prof. Priller)2023