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Impact of Atypical Antipsychotics on Quality of Life in Patients with Schizophrenia

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Abstract

Schizophrenia is a long-term disabling illness that affects approximately 1% of the population. Its course is generally chronic with acute psychotic exacerbations that may require frequent hospitalisations. The clinical picture includes a range of symptoms such as delusions, hallucinations, agitation, suspiciousness, hostility, conceptual disorganisation, blunted affect, emotional and social withdrawal, lack of spontaneity, poverty of speech and a wide range of neurocognitive deficits. Over the past 50 years, antipsychotic medications have emerged as the cornerstone of management in concert with other important interventions, such as psychosocial and economic support and rehabilitation efforts. However, the unrivalled role of conventional antipsychotic medications has been continuously challenged by the wide range of adverse effects of these medications and their lack of usefulness in the treatment of neurocognitive deficits as well as deficit and negative symptoms. In addition, the lack of subjective tolerability of these agents and their negative impact on quality of life have complicated management for a large number of patients. Over the last 15 years, several new atypical antipsychotic medications have been introduced, including amisulpride, remoxipride, risperidone, sertindole, olanzapine, zotepine, quetiapine, ziprasidone and aripiprazole. In general, the new antipsychotics have shown themselves to be at least comparable in efficacy to conventional antipsychotics but with superior subjective tolerability and a more favourable adverse effect profile.

The majority of quality of life studies involving new antipsychotic agents have evaluated the benefits of risperidone, olanzapine and clozapine; only a few studies have examined the effects of other new antipsychotics. While most of these studies have methodological and design limitations, the weight of evidence from them nevertheless points to a trend towards a more positive impact on quality of life with atypical agents.

A number of recommendations can be made. First, more independent well designed and controlled studies are urgently needed to evaluate the effects of antipsychotic therapy on quality of life in patients with schizophrenia. New comparative studies should explore not only the differences between new and old antipsychotics but also identify any potential differences between individual new agents. The role of cost-effectiveness studies such as cost utility approaches in schizophrenia needs to be revisited, notwithstanding the fact that these types of studies have been reported to be feasible in schizophrenia. Finally, quality-of-life-based pharmacoeconomic studies of antipsychotic agents should not concentrate solely on cost reduction or containment, as it is likely that in order to maximise the benefits of new antipsychotic medications, greater expenditure on rehabilitation programmes and other support services will be necessary in the short-term at least.

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References

  1. Davies LM, Drummond MF. The economic burden of schizophrenia. Psychiart Bull 1990; 14: 522–55

    Article  Google Scholar 

  2. Puech A, Fleurot O, Rein W. Amisulpride, an atypical antipsychotic in the treatment of acute episodes of schizophrenia: a dose ranging study vs haloperidol. Acta Psychiatr Scand 1998; 98: 65–72

    Article  PubMed  CAS  Google Scholar 

  3. Peuskens J, Bech P, Möller HJ, et al. Amisulpride vs risperidone in the treatment of acute exacerbations of schizophrenia. Psychiatry Res 1999; 88: 107–17

    Article  PubMed  CAS  Google Scholar 

  4. Lewander T, Westbergh S-E, Morrison D. Clinical profile of remoxipride: a combined analysis of a comparative double-blind multicentre trial program. Acta Psychiatr Scand 1990; 82 Suppl. 358: 92–8

    Article  CAS  Google Scholar 

  5. Lapierre YD, Ancill R, Awad AG, et al. A dose-finding study with remoxipride in the acute treatment of schizophrenic patients. J Psychiatr Neurosci 1992; 17: 135–45

    Google Scholar 

  6. Kane J, Honigfeld G, Singer J, et al. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlor-promazine. Arch Gen Psychiatry 1988; 45: 789–96

    Article  PubMed  CAS  Google Scholar 

  7. Lieberman JA, Safferman AZ, Pollack S, et al. Clinical effects of clozapine in chronic schizophrenia: response to treatment and predictors of outcome. Am J Psychiatry 1994; 151: 1744–52

    PubMed  CAS  Google Scholar 

  8. Lindenmayer JP, Grochowski S, Mabugat L. Clozapine effects of positive and negative symptoms: a six month trial in treatment-refractory schizophrenics. J Clin Psychopharmacol 1994; 14: 201–4

    Article  PubMed  CAS  Google Scholar 

  9. Chouinard G, Jones B, Remington G, et al. A Canadian multicentre placebo controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients. J Clin Psychopharmacol 1993; 13: 25–40

    Article  PubMed  CAS  Google Scholar 

  10. Marder SR, Meibach RC. Risperidone in the treatment of schizophrenia. Am J Psychiatry 1994; 151: 825–35

    PubMed  CAS  Google Scholar 

  11. Peuskens J, and the Risperidone Study Group. Risperidone in the treatment of patients with chronic schizophrenia: a multinational, multicentre, double-blind, parallel group study vs haloperidol. Br J Psychiatry 1995; 166: 712–26

    Article  PubMed  CAS  Google Scholar 

  12. Beasley CM, Tollefson GD, Tran PV, et al. Olanzapine vs placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial. Neuropsychopharmacology 1996; 14: 111–23

    Article  PubMed  CAS  Google Scholar 

  13. Tollefson GD, Beasley CM, Tran PV, et al. Olanzapine vs haloperidol in the treatment of schizophrenia and schizophreniform disorders: results of an international collaborative trial. Am J Psychiatry 1997; 154: 457–65

    PubMed  CAS  Google Scholar 

  14. Tran PV, Hamilton SH, Kuntz AJ, et al. Double-blind comparison of olanzapine vs risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol 1997; 17: 407–18

    Article  PubMed  CAS  Google Scholar 

  15. Martin PT, Grebb GA, Schmitz PJ, et al. Efficacy and safety of sertindole in double-blind, placebo-controlled trials of schizophrenic patients [abstract]. Schizophr Res 1994; 11: 107

    Google Scholar 

  16. Daniel DG, Wozniak P, Mack RJ, et al. Long-term efficacy and safety comparison of sertindole and haloperidol in the treatment of schizophrenia. Psychopharmacol Bull 1998; 34: 61–9

    PubMed  CAS  Google Scholar 

  17. Arvantis LA, Miller BG, the Seroquel Trial-13 Study Group. Multiple fixed doses of Seroquel (quetiapine) in patients with acute exacerbation of schizophrenia: a comparison with haloperidol and placebo. Biol Psychiatry 1997; 42: 233–46

    Article  Google Scholar 

  18. van Kammen DP, Targum SD, Sebree TB. Switching antipsychotic medications. J Clin Psychiatry 1997; 58: 63–72

    Google Scholar 

  19. Small J, Hirsch S, Arvantis LA, et al. Quetiapine in patients with schizophrenia: a high and low dose double-blind comparison with placebo. Arch Gen Psychiatry 1997; 54: 549–57

    Article  PubMed  CAS  Google Scholar 

  20. Müller-Spahn F, Dieterle D, Ackenheil M. Clinical efficacy of zotepine in the treatment of negative symptoms: results of an open and a double-blind controlled trial [in German]. Fortscher Neurol Psychiatr 1991; 59 Suppl. 1: 30–5

    Article  Google Scholar 

  21. Petit M, Raniwalla J, Tweed J, et al. A comparison of an atypical and typical antipsychotic, zotepine vs haloperidol in patients with acute exacerbation of schizophrenia: a parallel group double-blind trial. Psychopharmacol Bull 1996; 32: 81–7

    PubMed  CAS  Google Scholar 

  22. Keck P, Buffenstein A, Ferguson J, et al. Ziprasidone 40 and 120 mg/day in the acute exacerbation of schizophrenia and schizoaffective disorder: a 4-week placebo-controlled trial. Psychopharmacology (Berl) 1998; 140: 173–84

    Article  CAS  Google Scholar 

  23. Daniel DG, Zimbroff DL, Potkin SG, et al. Ziprasidone 40mg bid and 80mg bid in the acute exacerbation of schizophrenia and schizoaffective disorder: results of a six-week placebo controlled trial. Neuropsychopharmacology 1999; 20: 491–505

    Article  PubMed  CAS  Google Scholar 

  24. Carson WH, Lieberman J, Pigott T, et al. Aripiprazole vs placebo in the treatment of stable chronic schizophrenia [abstract]. 41st Annual Meeting of the American College of Neuropsychopharmacology; 2002 Dec 8–12; San Juan

  25. Bourin MS, McQuade RD, Carson WH, et al. Aripiprazole for long-term maintenance treatment of schizophrenia [abstract]. 41st Annual Meeting of the American College of Neuropsychopharmacology; 2002 Dec 8–12; San Juan

  26. Wagstaff AJ, Bryson HM. Clozapine. A review of its pharmacological properties and therapeutic use in patients with schizophrenia who are unresponsive to or intolerant of classical antipsychotic agents. CNS Drugs 1995; 4: 370–400

    CAS  Google Scholar 

  27. Foster RH, Goa KL. Risperidone. A pharmacoeconomic review of its use in schizophrenia. Pharmacoeconomics 1998; 14: 97–133

    CAS  Google Scholar 

  28. Fulton B, Goa KL. Olanzapine: a review of its pharmacological properties and therapeutic efficacy in the management of schizophrenia and related psychoses. CNS Drugs 1997; 53: 281–98

    CAS  Google Scholar 

  29. Gunasekara NS, Spencer CM. Quetiapine: a review of its use in schizophrenia. CNS Drugs 1998; 9: 325–40

    Article  CAS  Google Scholar 

  30. Prakash A, Lamb HM. Zotepine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the management of schizophrenia. CNS Drugs 1998; 9: 153–75

    Article  CAS  Google Scholar 

  31. Davis SR, Markham A. Ziprasidone. CNS Drugs 1997; 8: 153–62

    Article  CAS  Google Scholar 

  32. Kerwin RW, Taylor D. New antipsychotics: a review of their current status and clinical practice. CNS Drugs 1996; 6: 71–82

    Article  CAS  Google Scholar 

  33. Worrell GA, Marken P, Beckman S, et al. Atypical antipsychotic agents: a critical review. Am J Health Syst Pharm 2000; 57: 238–55

    Google Scholar 

  34. Awad AG, Voruganti LNP, Heslegrave RJ. The aims of antipsychotic medication: what are they and are they being achieved? CNS Drugs 1995; 4: 8–16

    Article  Google Scholar 

  35. Fleishhacker W, Hummer M. Drug treatment of schizophrenia, achivements and future possibilities in optimising outcomes. In: Mallarkey G, editor. Managing schizophrenia. Auckland: Adis International, 1999: 19–34

    Google Scholar 

  36. Calman KC. Quality of life in cancer patients: a hypothesis. J Med Ethics 1984; 10: 124–7

    Article  PubMed  CAS  Google Scholar 

  37. Wood-Dauphinee S, Williams JI. Reintegration in normal living as a proxy to quality of life. J Chronic Dis 1987; 40: 491–502

    Article  PubMed  CAS  Google Scholar 

  38. Ware JE. Conceptualizing disease impact and treatment outcomes. Cancer 1984; 53: 2316–23

    PubMed  Google Scholar 

  39. Awad AG, Voruganti LNP. Intervention research in psychosis: issues related to the assessment of quality of life. Schizophr Bull 2000; 26: 557–64

    Article  PubMed  CAS  Google Scholar 

  40. Heslegrave RJ, Voruganti LNP, Awad AG. The influence of neurocognitive deficits and symptoms on quality of life in schizophrenia. J Psychiatry Neurosci 1997; 22: 235–43

    PubMed  CAS  Google Scholar 

  41. Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996; 153: 321–30

    PubMed  CAS  Google Scholar 

  42. Brekke JS, Kohrt B, Green MF. Neuropsychological functioning as a moderator of the relationship between psychosocial functioning and the subjective experience of self and life in schizophrenia. Schizophr Bull 2001; 27: 697–708

    Article  PubMed  CAS  Google Scholar 

  43. Awad AG, Voruganti LNP, Heslegrave RJ. Preliminary validation of a conceptual model to assess quality of life in schizophrenia. Qual Life Res 1997; 6: 21–6

    Article  PubMed  CAS  Google Scholar 

  44. Ritsner M, Ponizovoskya P, Endicott J, et al. Relatively small impact adverse events of antipsychotics on life satisfaction of schizophrenia patients: a naturalistic study. Eur Neuropsychopharmacol 2002; 12: 31–8

    Article  PubMed  CAS  Google Scholar 

  45. Awad AG, Voruganti LNP, Heslegrave RJ. Measuring quality of life in patients with schizophrenia. Pharmacoeconomics 1997; 11: 32–47

    Article  PubMed  CAS  Google Scholar 

  46. Jeste DV, Klausner M, Brecher M, et al. A clinical evaluation of risperidone in the treatment of schizophrenia: a 10-week open label multicentre trial. Psychopharmacology (Berl) 1997; 131: 239–47

    Article  CAS  Google Scholar 

  47. Endicott J, Spitzer RL, Fleiss JL, et al. The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976; 33: 766–71

    Article  PubMed  CAS  Google Scholar 

  48. Heinrichs DW, Hanlon TE, Carpenter WT. The quality of life scale: an instrument for rating the schizophrenic deficit symptoms. Schizophr Bull 1984; 10: 388–98

    Article  PubMed  CAS  Google Scholar 

  49. Barcia D, Ayuso JL, Herraiz ML, et al. Calidad de vida en pacientes esquizofrenicos tratados con risperidona. An Psiquiatr 1996; 12: 403–12

    Google Scholar 

  50. Bobes J, Gutierrez M, Gibert J, et al. Quality of life in schizophrenia: long-term follow-up in 362 chronic Spanish schizophrenic outpatients undergoing risperidone maintenance treatment. Eur Psychiatry 1998; 13: 158–63

    Article  PubMed  CAS  Google Scholar 

  51. McHorney CA, Wate JE, Lu R, et al. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality scaling assumptions and reliability across diverse patient groups. Med Care 1994; 32: 40–66

    CAS  Google Scholar 

  52. Brescan DW, Ramirez LF. Effect of risperidone on quality of life [abstract]. Qual Life Res 1997; 6: 626

    Google Scholar 

  53. Lehman AF. Quality of life tool kit. Cambridge (MA): The Evaluation Centre, 1995

    Google Scholar 

  54. Heinsch M, Ludwig M, Bullinger M. Psychometrische Testung der; Muncher Lebensqualitats Dimensionen Liste (MLDL). In: Bullinger M, Ludwig M, von Steinbuche N, editors. Lebensqualitat bei Kardovaskularen Erkrankungen. Gottingen: Hogrefe, 1991: 73–90

    Google Scholar 

  55. Franz M, Lis S, Pluddemann K, et al. Conventional vs atypical neuroleptics: subjective quality of life in schizophrenia patients. Br J Psychiatry 1997; 170: 422–5

    Article  PubMed  CAS  Google Scholar 

  56. Tran PV, Hamilton SH, Kunz AJ, et al. Double-blind comparison of olanzapine vs risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol 1997; 17: 407–18

    Article  PubMed  CAS  Google Scholar 

  57. Mahmoud RA, Engelhart LM, Oster G, et al. Risperidone vs conventional antipsychotics: a prospective randomized naturalistic effectiveness trial of outcomes in chronic schizophrenia. 36th Annual Meeting of the American College of Neuropsychopharmacology; 1997 Dec 8–12; Hawaii

  58. Huybrechts K. Outcomes assessment in schizophrenia: methodological issues. Schizophr Rev 1996; 3 Suppl. 4: 2–3

    Google Scholar 

  59. Jette AM. Concepts of health and methodological issues in functional assessment. In: Granger CV, Gresham GE, editors. Functional assessments in rehabilitation medicine. Baltimore (MD): Williams and Wilkins, 1984

    Google Scholar 

  60. Mahmoud RA, Engelhart LM, Rothman M, et al. Assessment of symptoms affecting quality of life and patient satisfaction with antipsychotic drugs: new tools and insights from a trial of risperidone vs olanzapine [poster]. 37th Annual Meeting of the American College of Neuropsychopharmacol; 1998 Dec 14–18; San Juan

  61. Awad AG. Quality of life issues in medicated schizophrenics: therapeutic and research implications. In: Shriqui C, Nasralla H, editors. Contemporary issues in the treatment of schizophrenia. Washington: American Psychiatric Press, 1995: 735–47

    Google Scholar 

  62. Tempier R, Pawliuk N. Influence of novel and conventional antipsychotic medication on subjective quality of life. J Psychiatry Neurosci 2001; 26: 131–6

    PubMed  CAS  Google Scholar 

  63. Baker F, Intagliata J. Quality of life in the evaluation of community support systems. Eval Program Plann 1982; 5: 69–79

    Article  PubMed  CAS  Google Scholar 

  64. Voruganti LNP, Cortese L, Oyewumi L, et al. Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability, side effects profile and impact on quality of life. Schizophr Res 2000; 43: 135–45

    Article  PubMed  CAS  Google Scholar 

  65. Voruganti LNP, Cortese L, Oyewumi L, et al. Switching from conventional to novel antipsychotic drugs: results of a prospective naturalistic study. Schizophr Res 2002; 57: 201–8

    Article  PubMed  CAS  Google Scholar 

  66. Hamilton SH, Revicki DA, Edgell ET, et al. Clinical and economic outcomes of olanzapine compared with haloperidol for schizophrenia: results from a randomized clinical trial. Pharmacoeconomics 1999; 15: 469–80

    Article  PubMed  CAS  Google Scholar 

  67. Revicki DA, Ginduso LA, Hamilton SH, et al. Olanzapine vs haloperidol in the treatment of schizophrenia and other psychotic disorders: quality of life and clinical outcomes of a randomized clinical trial. Qual Life Res 1999; 8: 417–26

    Article  PubMed  CAS  Google Scholar 

  68. Ho BC, Miller D, Nopoulos P, et al. A comparative effectiveness study of risperidone and olanzapine in the treatment of schizophrenia. J Clin Psychiatry 1999; 60: 658–63

    Article  PubMed  CAS  Google Scholar 

  69. Naber D, Moritz S, Lambert M, et al. Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs. Schizophr Res 2001; 50: 79–88

    Article  PubMed  CAS  Google Scholar 

  70. Meltzer HY, Burnett S, Bastani B, et al. Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hosp Community Psychiatry 1990; 41: 892–7

    PubMed  CAS  Google Scholar 

  71. Meltzer HY, Okayli G. Reduction of suicidality during clozapine treatment of neuroleptic-resistant schizophrenia: impact on risk benefit assessment. Am J Psychiatry 1995; 152: 183–90

    PubMed  CAS  Google Scholar 

  72. Naber D. A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol 1995; 10 Suppl. 3: 133–8

    Google Scholar 

  73. Essock SM, Hargreaves WA, Covell NH, et al. Clozapine’s effectiveness for patients in state hospitals: results from a randomized trial. Psychopharmacol Bull 1996; 32: 683–97

    PubMed  CAS  Google Scholar 

  74. Rosenheck R, Cramer J, Xu W, et al. A comparison of clozapine and haloperidol in hospitalized patients with refractory schizophrenia. N Engl J Med 1997; 337: 809–15

    Article  PubMed  CAS  Google Scholar 

  75. Colonna L, Turjanski S, Dondey-Nouvel L. Amisulpride: long-term efficacy and safety [abstract]. Eur Psychiatry 1998; 13: 309

    Article  Google Scholar 

  76. Saleem P, Olie JP, Loo H. Social functioning quality of life in the schizophrenic patient: advantages of amisulpride. Int Clin Psychopharmacol 2002; 17: 1–8

    Article  PubMed  CAS  Google Scholar 

  77. Awad AG, Lapierre YD, Angus C, et al. Quality of life and response of negative symptoms in schizophrenia to haloperidol and the atypical antipsychotic remoxipride. J Psychiatry Neurosci 1997; 22: 244–8

    PubMed  CAS  Google Scholar 

  78. Hellewell JS, Kalali AH, Langham SJ, et al. Patient satisfaction and acceptability of long-term treatment with quetiapine. Int J Psychiatry Clin Pract 1999; 3: 105–13

    Article  CAS  Google Scholar 

  79. Voruganti LNP, Awad AG. Personal Evaluation of Transitions in Treatment (PETiT): a scale to measure subjective aspects of antipsychotic drug therapy in schizophrenia. Schizophr Res 2002; 56: 37–46

    Article  PubMed  Google Scholar 

  80. Awad AG, Voruganti LNP, Mackell JA, et al. Patient attitude after switch to ziprasidone from other antipsychotics [abstract]. 11th Congress at the Association of European Psychiatrists; 2002 May 4–8; Stockholm

  81. Daniel DG, Weiden PJ, O’Sullivan R. Improvement in indices of health status in outpatients with schizophrenia, following a switch to ziprasidone from conventional antipsychotics, olanzapine or risperidone [abstract]. 13th European College of Neuropsychopharmacology Congress; 2000 Sep 9–13; Munich

  82. Awad AG. Subjective response to neuroleptics in schizophrenia. Schizophr Bull 1993; 19: 609–18

    Article  PubMed  CAS  Google Scholar 

  83. Van Putten T, May PRA. Subjective response as a predictor of outcome in pharmacotherapy. Arch Gen Psychiatry 1978; 35: 477–80

    Article  PubMed  Google Scholar 

  84. Van Putten T, May PRA, Murder SR. Subjective response to antipsychotic drugs. Res Gen Psychiatry 1981; 38: 187–90

    Article  Google Scholar 

  85. Voruganti L, Awad AG. Neuroleptic dysphoria: toward a new synthesis. Psychopharmacology (Berl) 2004; 171(2): 121–32

    Article  CAS  Google Scholar 

  86. Hogan TP, Awad AG, Eastwood MR. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminate ability. Psychol Med 1983; 13: 177–83

    Article  PubMed  CAS  Google Scholar 

  87. Awad AG, Hogan TP. Early treatment events and prediction of response to neuroleptics in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 1985; 9: 585–8

    Article  PubMed  CAS  Google Scholar 

  88. Weiden PJ, Dixon L, Francis A, et al. Neuroleptic Non-compliance in Schizophrenia. In: Tamminga C, Schulz SC, editors. Advances in neuropsychiatry and psychopharmacology. Vol. 1. New York: Raven Press, 1991: 285–95

    Google Scholar 

  89. Naber D, Walther A, Kirche T, et al. Subjective effects of neuroleptics predict compliance in prediction of neuroleptic treatment outcome in schizophrenia. In: Gaebel W, Awad AG, editors. Concepts and methods. Heidelberg: Springer Verlag, 1994: 111–22

    Google Scholar 

  90. Awad AG, Voruganti LNP, Heslegrave RJ. Assessment of the patient’s subjective experiences in acute neuroleptic treatment: implications for compliance and outcome. Int Clin Psychopharmacol 1996; 11 Suppl. 2: 55–60

    Article  Google Scholar 

  91. Awad AG. Antipsychotic medications: compliance and attitudes towards treatment. Curr Opin Psychiatry 2004; 17: 75–80

    Article  Google Scholar 

  92. Voruganti LNP, Heslegrave RJ, Awad AG. Neuroleptic dysphoria may be the missing link between schizophrenia and substance abuse. J Nerv Ment Dis 1997; 185: 463–5

    Article  PubMed  CAS  Google Scholar 

  93. Awad AG. Quality of life of schizophrenic patients on medications and implications for new drug trials. Hosp Community Psychiatry 1992; 43: 262–5

    PubMed  CAS  Google Scholar 

  94. Awad AG, Hogan TP. Subjective response to neuroleptics and the quality of life: implications for treatment outcome. Acta Psychiatr Scand Suppl 1994; 89(380): 27–32

    Article  Google Scholar 

  95. MacIntosh E, Cheng S, Richeng S, et al. The relationship of symptoms and level of functioning in schizophrenia to general well-being and the quality of life scale. Acta Psychiatr Scand 2000; 102: 303–9

    Article  Google Scholar 

  96. Larsen EB, Gerlach J. Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic outpatients treated with depot neuroleptics. Acta Psychiatr Scand 1996; 93: 381–8

    Article  PubMed  CAS  Google Scholar 

  97. Brownie S, Garaven J, Gervin M, et al. Quality of life in schizophrenia: insight and subjective response to neuroleptics. J Nerv Ment Dis 1998; 186: 74–8

    Article  Google Scholar 

  98. Tollefson GD, Andersen SW. Should we consider mood disturbances in schizophrenia as an important determinant of quality of life? J Clin Psychiatry 1999; 60Suppl. 5: 23–9

    PubMed  CAS  Google Scholar 

  99. Lyness WH, Fiddel NM, More KE. Destruction of dopaminergic nerve terminals in nucleus accumbens: effect on d-amphetamine self-administration. Pharmacol Biol Behav 1979; 11: 552–6

    Google Scholar 

  100. Roberts DC, Corcoran ME, Fibiger HC. On the role of ascending catecholamenergic systems in intravenous self-administration of cocaine. Pharmacol Biochem Behav 1977; 6: 615–20

    Article  PubMed  CAS  Google Scholar 

  101. Voruganti LNP, Slomka P, Zabel P, et al. Subjective effects of AMPT-induced dopamine depletion in schizophrenia: correlation between dysphoric responses and striatal D2 binding ratios on SPECT-imaging. Neuropsychopharmacology 2001; 25: 642–50

    Article  PubMed  CAS  Google Scholar 

  102. de Haan L, Lavalaye J, Linszend D, et al. Subjective experience and striatal dopamine D2 receptor occupancy in patients with schizophrenia stabilized by olanzapine or risperidone. Am J Psychiatry 2000; 157: 1019–20

    Article  PubMed  Google Scholar 

  103. Awad AG, Voruganti LN. New antipsychotics, compliance, quality of life, and subjective tolerability: are patients better off? Can J Psychiatry 2004; 49(5): 297–302

    PubMed  Google Scholar 

  104. Awad AG, Voruganti LNP. Quality of life and new antipsychotics in schizophrenia: are patients better off? Int J Soc Psychiatry 1999; 45: 268–75

    Article  PubMed  CAS  Google Scholar 

  105. Awad AG, Voruganti LNP. The subjective/objective dichotomy in schizophrenia: relevance to nosology, research and management. In: Gaebel W, editor. Zukunftsperspektiven in Psychiatries Und Psychotherapie. Darmstadt: Steinkopff Verlag, 2002: 21–7

    Chapter  Google Scholar 

  106. Hargreaves WA, Shumway M. Pharmacoeconomics of antipsychotic drug therapy. J Clin Psychiatry 1996; 57 Suppl. 9: 66–76

    Google Scholar 

  107. Revicki D. Pharmacoeconomic studies of atypical antipsychotic drugs for the treatment of schizophrenia. Schizophr Res 1999; 35: 101–9

    Article  Google Scholar 

  108. Addington DE, Jones B, Bloom D, et al. Reduction of hospital days in chronic schizophrenic patients treated with risperidone: a retrospective study. Clin Ther 1993; 15: 917–26

    PubMed  CAS  Google Scholar 

  109. Albright PS, Livingston S, Keegan DL, et al. Reduction of health care resource utilization and costs following the use of risperidone for patients with schizophrenia previously treated with standard antipsychotic therapy: a retrospective analysis using the Saskatchewan health linkage data bases. Clin Drug Invest 1996; 11: 289–99

    Article  Google Scholar 

  110. Guest JF, Hart WM, Cookson RF, et al. Pharmacoeconomic evaluation of long-term treatment with risperidone for patients with chronic schizophrenia. Br J Med Econ 1996; 10: 59–67

    Google Scholar 

  111. Reid WH, Mason M, Toprac M. Savings in hospital bed-days related to treatment with clozapine. Hosp Community Psychiatry 1994; 45: 261–3

    PubMed  CAS  Google Scholar 

  112. Dickson RA. Hospital days in clozapine-treated patients. Can J Psychiatry 1998; 43: 945–8

    PubMed  CAS  Google Scholar 

  113. Zito JM. Pharmacoeconomics of the new antipsychotics for the treatment of schizophrenia. Psychiatric Clin North Am 1998; 21: 181–202

    Article  CAS  Google Scholar 

  114. Awad AG, Voruganti LNP. Cost-utility analysis in schizophrenia. J Clin Psychiatry 1999; 60 Suppl. 3: 22–6

    Google Scholar 

  115. Voruganti LNP, Awad AG, Oyewumi LK, et al. Assessing health utilities in schizophrenia: a feasibility study. Pharmacoeconomics 2000; 17: 273–86

    Article  PubMed  CAS  Google Scholar 

  116. Karow A, Naber D. Subjective wellbeing and quality of life under atypical antipsychotic treatment. Psychopharmacology 2002; 162: 3–10

    Article  PubMed  CAS  Google Scholar 

  117. Ritsner M, Kurs R. Impact of antipsychotic agents and their side-effects on the quality of life in schizophrenia. Expert Rev Pharmacoeconomics Outcomes Res 2002; 2: 89–98

    Article  Google Scholar 

  118. Awad AG. Antipsychotic medications in schizophrenia: how satisfied are our patients? In: Hellewell J, editor. Clear perspectives. Vol. 2. London: Shire Hall International, 1999: 1–6

    Google Scholar 

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  1. Institute of Medical Science and Department of Psychiatry, University of Toronto, Humber River Regional Hospital, Toronto, Ontario, Canada

    A. George Awad

  2. Schizophrenia Research Program, McMaster University, Hamilton, Ontario, Canada

    Lakshmi N. P. Voruganti

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Awad, A.G., Voruganti, L.N.P. Impact of Atypical Antipsychotics on Quality of Life in Patients with Schizophrenia. CNS Drugs 18, 877–893 (2004). https://doi.org/10.2165/00023210-200418130-00004

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