Hostname: page-component-745bb68f8f-g4j75 Total loading time: 0 Render date: 2025-01-12T23:04:43.935Z Has data issue: false hasContentIssue false
  • English
  • Français

Amisulpride has a superior benefit/risk profile to haloperidol in schizophrenia: results of a multicentre, double-blind study (the Amisulpride Study Group*

Published online by Cambridge University Press:  16 April 2020

P. Carrière ,
D. Bonhomme  and
T. Lempérière
P. Carrière*
Affiliation:
Service Médico-Psychologique Régional, BP 549,36021Châteauroux, France
D. Bonhomme
Affiliation:
Sanofi Synthélabo-France, 22, avenue Galilée,92352le Plessis Robinson, France
T. Lempérière
Affiliation:
28 rue des Acacias,75017Paris, France
*
*Correspondence and reprints
Get access

Summary

In a multicentre, double-blind, flexible-dose study, 199 patients with paranoid schizophrenia or schizophreniform disorders received haloperidol (10–30 mg/d) or amisulpride (400–1200 mg/d) for four months. More patients in the haloperidol group withdrew prematurely (44% vs 26%; P = 0.0077) due to a higher incidence of adverse events. Amisulpride was at least as effective as haloperidol in reducing the Brief Psychiatric Rating Scale (BPRS) total score (–27.3 vs –21.9) (non-inferiority test; P < 0.001). The PANSS positive score improved to a similar extent in both groups whilst improvement in the PANSS negative score was significantly greater with amisulpride (–10.5 vs –7.2; P = 0.01). The percentage of responders on the Clinical Global Impression scale was also significantly greater with amisulpride (71% vs 47%; P < 0.001). Both the Quality of Life Scale (QLS) and the Functional Status Questionnaire (FSQ) improved to a significantly greater extent under amisulpride. Haloperidol was associated with a greater incidence in extrapyramidal symptoms and with a greater increase in the Simpson-Angus score than was seen with amisulpride (0.32 vs 0.02; P < 0.001). In conclusion, amisulpride is globally superior to haloperidol in the treatment of acute exacerbations of schizophrenia and significantly improves patients’ quality of life and social adjustment.

Keywords

amisulprideantipsychoticatypical antipsychotichaloperidolschizophrenia
Type
Original Article
Information
European Psychiatry , Volume 15 , Issue 5 , August 2000 , pp. 321 - 329
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association Practice guideline for the treatment of patients with schizophrenia Am J Psychiatry 154 Suppl 4 1997 1–63CrossRefGoogle Scholar
Arvanitis, L.A.Miller, B.G.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 42 1997 233–24610.1016/S0006-3223(97)00190-XCrossRefGoogle ScholarPubMed
Beasley, C.M.Sanger, T.Satterlee, W.Tollefson, G.Tran, P.Hamilton, S. et al. Olanzapine versus placebo: results of a double-blind, fixed-dose olanzapine trial Psychopharmacology 124 1996 159–16710.1007/BF02245617CrossRefGoogle ScholarPubMed
Beasley, C.M.Tollefson, G.D.Tran, P.Satterlee, W.Sanger, T.Hamilton, S. et al. Olanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial Neuropsychopharmacology 14 1996 105–118CrossRefGoogle ScholarPubMed
Casey, D.E.Motor and mental aspects of extrapyramidal syndromes Int Clin Psychopharmacol 10 Suppl 3 1995 105–114Google ScholarPubMed
Chabannes, J.P.Pelissolo, A.Farah, S.Gérard, D.Evaluation de l’efficacité et de la tolérance de l’amisulpride dans le traitement des psychoses schizophréniques L’Encéphale 24 1998 386–392Google Scholar
Chouinard, G.Jones, B.Remington, G.Bloom, D.Addington, D.MacEwan, G.W. et al. A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients J Clin Psychopharmacol 13 1993 25–4010.1097/00004714-199302000-00004CrossRefGoogle ScholarPubMed
Chouinard, G.Albright, P.Utility analysis of risperidone cost effectiveness J Clin Psychopharmacol 17 1997 298–30710.1097/00004714-199708000-00010CrossRefGoogle Scholar
Cole, J.O.Goldberg, S.C.Davis, J.M.Drugs in the treatment of psychosis: controlled studiesSolomon, PPsychiatric drugs 1966 Grune and Stratton New York153–180Google Scholar
Collaborative Working Group on Clinical Trial Evaluations Measuring outcome in schizophrenia: differences among the atypical antipsychotics J Clin Psychiatry 59 Suppl 12 1998 3–9Google Scholar
Collaborating Working Group on Clinial Trial Evaluations Evaluating the effects of antipsychotics on cognition in schizophrenia J Clin Psychiatry 59 Suppl 12 1998 35–40Google Scholar
Colonna, L.Saleem, P.Dondey-Nouvel, L.Rein, W.Long-term safety and efficacy of amisulpride in subchronic or chronic schizophrenia Int Clin Psychopharmacol 15 2000 13–2210.1097/00004850-200015010-00002CrossRefGoogle ScholarPubMed
Csernansky, J.G.Wrona, C.T.Bardgett, M.E.Early, T.S.Newcomer, J.W.Subcortical dopamine and serotonin turnover during acute and subchronic administration of typical and atypical neuroleptics Psychopharmacology 110 1993 145–151CrossRefGoogle ScholarPubMed
Danion, J.M.Rein, W.Fleurot, O.the Amisulpride study group Improvement of schizophrenic patients with primary negative symptoms treated with amisulpride Am J Psychiatry 156 1999 610–616Google ScholarPubMed
Glazer, W.M.Formulary decisions and health economics J Clin Psychiatry 59 Suppl 19 1998 23–29Google ScholarPubMed
Guy, W.ECDEU assessment manual for psychopharmacology.Publication ADM 76–338 Rockville Md: US Department of Health Education and Welfare 217–222Google Scholar
Heinrichs, D.W.Hanlon, T.E.Carpenter, W.T. JrThe quality of life scale: an instrument for rating the schizophrenic deficit syndrome Schizophr Bull 10 1984 388–39610.1093/schbul/10.3.388CrossRefGoogle ScholarPubMed
Ho, B.C.Miller, D.Nopoulos, P.Andreasen, N.C.A comparative effectiveness study of risperidone and olanzapine in the treatment of schizophrenia J Clin Psychiatry 60 1999 658–663CrossRefGoogle ScholarPubMed
Jette, A.M.Davies, A.R.Cleary, P.D.Calkins, D.R.Rubenstein, L.V.Fink, A. et al. The functional status questionnaire: reliability and validity when used in primary care J Gen Int M 1 1986 143–14910.1007/BF02602324CrossRefGoogle ScholarPubMed
Kay, S.Opler, L.The positive-negative dimension in schizophrenia: its validity and significance Psychiatr Dev 2 1987 79–103Google Scholar
Kay, S.R.Fiszbein, A.Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia Schizophr Bull 13 1987 261–27610.1093/schbul/13.2.261CrossRefGoogle Scholar
Marder, S.R.Meibach, R.C.Risperidone in the treatment of schizophrenia Am J Psychiatry 151 1994 825–835Google ScholarPubMed
Möller, H.J.Boyer, P.Fleurot, O.Rein, W.PROD-ASLP Study Group Improvement of acute exacerbations of schizophrenia with amisulpride: a comparison with haloperidol Psychopharmacology 132 1997 396–401Google ScholarPubMed
Overall, J.F.Gorham, D.R.The Brief Psychiatric Rating Scale Psychol Rep 10 1962 799–812CrossRefGoogle Scholar
Perrault, G.H.Depoortere, R.Morel, E.Sanger, D.J.Scatton, B.Psychopharmacological profile of amisulpride: an antipsychotic drug with presynaptic D2/D3 dopamine receptor antagonist activity and limbic selectivity J Pharmacol Exp Ther 280 1997 73–82Google ScholarPubMed
Peuskens, J.Bech, P.Möller, H.J.Bale, R.Fleurot, O.Rein, W.Amisulpride study group Amisulpride vs risperidone in the treatment of acute exacerbations of schizophrenia Psychiatry Res 88 1999 107–11710.1016/S0165-1781(99)00075-XCrossRefGoogle ScholarPubMed
Puech, A.J.Fleurot, O.Rein, W.the Amisulpride Study Group Amisulpride, an atypical antipsychotic, in the treatment of acute episodes of schizophrenia: a dose-ranging study vs. haloperidol Acta Psychiatr Scand 98 1998 65–7210.1111/j.1600-0447.1998.tb10044.xCrossRefGoogle ScholarPubMed
Rifkin, A.Doddi, S.Karajgi, B.Borenstein, M.Wachspress, M.Dosage of haloperidol for schizophrenia Arch Gen Psychiatry 48 1991 166–170CrossRefGoogle Scholar
Scatton, B.Claustre, Y.Cudennec, A.Oblin, A.Perrault, G.Sanger, D.J. et al. Amisulpride: from animal pharmacology to therapeutic action Int Clin Psychopharmacol 12 Suppl 2 1997 S29–S36CrossRefGoogle ScholarPubMed
Schoemaker, H.Claustre, Y.Fage, D.Rouquier, L.Chergui, K.Curet, O. et al. Neurochemical characteristics of amisulpride, an atypical dopamine D2/D3 receptor antagonist with both presynaptic and limbic selectivity J Pharmacol Exp Ther 280 1997 83–97Google ScholarPubMed
Simpson, G.Angus, J.A.A rating scale for extrapyramidal side effects Acta Psychiatr Scand 45 Suppl 212 1970 11–19CrossRefGoogle Scholar
Small, J.G.Hirsch, S.R.Arvanitis, L.A.Miller, B.G.Link, C.G.G.the Seroquel Study Group Quetiapine in patients with schizophrenia Arch Gen Psychiatry 54 1997 549–557CrossRefGoogle ScholarPubMed
Tran, P.V.Hamilton, S.H.Kuntz, A.J.Potvin, J.H.Andersen, S.W.Beasley, C. et al. Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders J Clin Psychopharmacol 17 1997 407–418CrossRefGoogle ScholarPubMed
Van Kammen, D.P.McEvoy, K.P.Targum, S.D.Kardatzke, D.Seebree, T.B.the Sertindole Study Group A randomized, controlled, dose-ranging trial of sertindole in patients with schizophrenia Psychopharmacology 124 1996 168–175CrossRefGoogle ScholarPubMed
Van Putten, T.Marder, S.R.Mintz, J.A controlled dose comparison of haloperidol in newly admitted schizophrenic patients Arch Gen Psychiatry 47 1990 754–758CrossRefGoogle ScholarPubMed
Wetzel, H.Philipp, M.Hillert, A.Gattaz, W.F.Sauer, H.Adler, G. et al. Amisulpride versus flupenthixol in schizophrenia with predominantly positive symptomatology – a double-blind controlled study comparing a selective D2-like antagonist to a mixed D1/D2-like antagonist Psychopharmacology 137 1998 223–23210.1007/s002130050614CrossRefGoogle ScholarPubMed
Zimbroff, D.L.Kane, J.M.Tamminga, C.A.Daniel, D.G.Mack, R.J.Wozniak, P.J. et al. Controlled dose-response study of sertindole and haloperidol in the treatment of schizophrenia Am J Psychiatry 154 1997 782–791Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.