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Antipsychotic Monotherapy and Polypharmacy in the Treatment of Outpatients With Schizophrenia in the European Schizophrenia Outpatient Health Outcomes Study

Novick, Diego MD*†; Ascher-Svanum, Haya PhD; Brugnoli, Roberto MD§; Bertsch, Jordan MS; Hong, Jihyung MS*; Haro, Josep Maria MD, PhD

The Journal of Nervous and Mental Disease: July 2012 - Volume 200 - Issue 7 - p 637–643
doi: 10.1097/NMD.0b013e31825bfd95
Original Articles

This post hoc study used data from the naturalistic Schizophrenia Outpatient Health Outcomes study, assessing the factors associated with starting antipsychotic monotherapy and the annual rate and duration of antipsychotic monotherapy among patients initiating atypical antipsychotics (N = 6866). Descriptive and regression analyses were used. Factors associated with starting antipsychotic monotherapy at baseline were antipsychotic treatment for the first time, shorter duration of illness, less severe illness, and better social functioning. Baseline monotherapy was maintained throughout 12 months by 63.2% of patients and was significantly greater for olanzapine (66.8%) than for risperidone (62.8%), quetiapine (43.4%), or amisulpride (52.6%) (all p ≤ 0.01). The predicted mean number of days on baseline monotherapy was significantly longer for olanzapine than for risperidone, quetiapine, or amisulpride (all p < 0.01). Initiation of antipsychotic monotherapy at baseline is associated with select baseline patient characteristics. Olanzapine was found to have the highest monotherapy rate and the longest duration of maintained monotherapy, followed by risperidone, amisulpride, and quetiapine.

*Health Outcomes Research, Eli Lilly and Company, Windlesham, Surrey, United Kingdom; †Departament de Psiquiatría, Universitat Autònoma de Barcelona, Barcelona, Spain; ‡Global Health Outcomes, Eli Lilly and Company, Indianapolis, IN; §Fondazione italiana per lo studio della Schizophrenia, Rome, Italy; and ∥Parc Sanitari Joan de Deu, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain.

Send reprint requests to Diego Novick, MD, Eli Lilly and Company, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, United Kingdom. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.