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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
BMC Psychiatry. 2011; 11: 24.
Published online Feb 11, 2011. doi:  10.1186/1471-244X-11-24
PMCID: PMC3045883
Relapse according to antipsychotic treatment in schizophrenic patients: a propensity-adjusted analysis
Aurelie Millier,1 Emmanuelle Sarlon,2,3,4 Jean-Michel Azorin,5 Laurent Boyer,corresponding author6 Samuel Aballea,1 Pascal Auquier,6 and Mondher Toumicorresponding author7
1Creativ-Ceutical France, rue du Faubourg Saint-Honoré, 75008 Paris, France
2National Institute of Health and Medical Research, INSERM, U669, Maison de Solenn, Boulevard de Port Royal, 75679 Paris, France
3University of Paris-Sud and University of Paris Descartes, UMR-S0669, 75014 Paris, France
4Department of Public Health, Hospital Center, Creil/Senlis, 60309 Senlis, France
5Department of Psychiatry, University Hospital Ste-Marguerite, Boulevard Sainte-Marguerite, 13009 Marseille, France
6Department of Public Health, EA 3279 Research Unit, University Hospital, Boulevard Jean Moulin 13385 Marseille, France
7UCBL 1 - Chair of Market Access University Claude Bernard Lyon I, Decision Sciences & Health Policy, Boulevard du 11 Novembre 1918, 69622 Villeurbanne, France
corresponding authorCorresponding author.
Aurelie Millier: ami/at/; Emmanuelle Sarlon: Emmanuelle.Sarlon/at/; Jean-Michel Azorin: jean-michel.azorin/at/; Laurent Boyer: laurent.boyer/at/; Samuel Aballea: sab/at/; Pascal Auquier: pascal.auquier/at/; Mondher Toumi: mondher.toumi/at/
Received November 8, 2010; Accepted February 11, 2011.
To compare the rate of relapse as a function of antipsychotic treatment (monotherapy vs. polypharmacy) in schizophrenic patients over a 2-year period.
Using data from a multicenter cohort study conducted in France, we performed a propensity-adjusted analysis to examine the association between the rate of relapse over a 2-year period and antipsychotic treatment (monotherapy vs. polypharmacy).
Our sample consisted in 183 patients; 50 patients (27.3%) had at least one period of relapse and 133 had no relapse (72.7%). Thirty-eight (37.7) percent of the patients received polypharmacy. The most severely ill patients were given polypharmacy: the age at onset of illness was lower in the polypharmacy group (p = 0.03). Patients that received polypharmacy also presented a higher general psychopathology PANSS subscore (p = 0.04) but no statistically significant difference was found in the PANSS total score or the PANSS positive or negative subscales. These patients were more likely to be given prescriptions for sedative drugs (p < 0.01) and antidepressant medications (p = 0.03). Relapse was found in 23.7% of patients given monotherapy and 33.3% given polypharmacy (p = 0.16). After stratification according to quintiles of the propensity score, which eliminated all significant differences for baseline characteristics, antipsychotic polypharmacy was not statistically associated with an increase of relapse: HR = 1.686 (0.812; 2.505).
After propensity score adjustment, antipsychotic polypharmacy is not statistically associated to an increase of relapse. Future randomised studies are needed to assess the impact of antipsychotic polypharmacy in schizophrenia.
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