Abstract Details

Title Impact of Antipsychotic Treatment Switching in Patients With Schizophrenia, Bipolar Disorder, And Major Depressive Disorder

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 9-014

Objective To evaluate the risk of relapse for patients with schizophrenia (SZ), bipolar disorder (BP), and major depressive disorder (MDD) who switched antipsychotics compared with those who did not switch.

Background Antipsychotics are commonly used for maintenance treatment of SZ, BP, and MDD but can have significant side effects, such as extrapyramidal symptoms (EPS). Adherence to treatment is important for reducing the risk of relapse, but fear of side effects may prompt medication switching.

Design/Methods Medicaid claims from six US states spanning 6 years were retrospectively analyzed for antipsychotic switching versus non-switching. Outcomes for all patients with SZ, BD or MDD and for the subset of patients who also had ≥1 EPS diagnosis during the baseline period, measured during a 2-year study period, were time to first underlying disease relapse, psychiatric relapse, all-cause emergency room (ER) visit, all-cause inpatient (IP) admission and EPS diagnosis.

Results For patients who switched antipsychotics (n=10,548), mean time (months) to first underlying disease relapse (4.4 vs 5.2), psychiatric relapse (4.5 vs 5.2), ER visit (3.5 vs 4.2), IP admission (4.1 vs 4.8) and EPS diagnosis (5.1 vs 5.7) was significantly shorter than for patients who did not switch (n=31,644) treatment (all log-rank P<0.001). Similar findings were observed for those who switched antipsychotics (N=281) versus those who did not switch (N=617) in the subgroup with ≥1 EPS diagnosis (disease relapse: 4.5 vs 4.8, log-rank P<0.05; psychiatric relapse: 4.6 vs 4.9, log-rank P=0.09; IP admission: 4.0 vs 4.3, log-rank P<0.05; ER: 3.5 vs 3.9, log-rank P<0.05).

Conclusions These results show that mean time to disease/psychiatric relapse, all-cause ER visit, IP admission, and EPS diagnosis was significantly shorter for patients who switched antipsychotics than for those who did not switch, suggesting that switching is associated with an increased risk of relapse in patients with SZ, BP and MDD.

Authors/Disclosures
Benjamin Carroll PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file

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