Medication noncompliance of schizophrenic outpatients is an important problem in clinical practice, causing relapse and illness deterioration. Because atypical neuroleptics have, in controlled clinical studies, been shown to be better tolerated and accepted by patients, the question is whether switching from conventional to atypical neuroleptics such as amisulpride can increase patient compliance also under conditions of routine care.
In a drug utilization observation study 570 schizophrenic outpatients, who had been pretreated with conventional neuroleptics and then been switched for individual clinical reasons to amisulpride, were observed for 3 months. Sociodemographic, illness and treatment related variables (e.g. Positive and Negative Symptom Scale, side effects), patients' subjective attitudes, and premedication and treatment compliance were assessed using standardized instruments.
A total of 43.7% were rated as being noncompliant with the premedication, while 85.8% were rated as compliant after being switched to amisulpride, including 82.7% of the former noncompliant patients. Patients who had become compliant showed a signicantly better psychopathological status after 3 months as compared to still noncompliant patients, including a lower rate of inpatient stays.
Switching noncompliant patients from conventional to atypical neuroleptics like amisulpride can improve patient compliance and psychopathology under conditions of routine treatment.
Albus M , Burkes S , Scherer J (1995) Welche Faktoren beeinflussen die Medikamenten-Compliance?Psychiatrische Praxis22: 228–230
2.
Aquila R , Weiden P J , Emanuel M (1999) Compliance and the rehabilitation alliance . Journal of Clinical Psychiatry60(Suppl. 19): 23–27
3.
Awad A G (1993) Subjective response to neuroleptics in schizophrenia . Schizophrenia Bulletin19(3): 609–619
4.
Barrett S L , Bell R , Watson D , King D J (2004) Effects of amisulpride, risperidone and chlorpromazine on auditory and visual latent inhibition, prepulse inhibition, executive function and eye movements in healthy volunteers . Journal of Psychopharmacology18: 156–172
5.
Bartkó G , Herczeg I , Zádor G (1988) Clinical symptomatology and drug compliance in schizophrenic patients . Acta Psychiatrica Scandinavica77: 74–76
6.
Blin O (2000) L'amisulpride: quelle place dans la réinsertion du patient schizophrène présentant des exacerbations aiguës . L'Encéphale26(Spec 1): 7–11
7.
Buchanan A (1992) A two-year prospective treatment compliance in patients with schizophrenia . Psychological Medicine22: 787–797
8.
Burns T , Chabannes J P , Demyttenaere K (2002) Switching antipsychotic medication: general recommendations and switching to amisulpride . Current Medical Research and Opinion18(4): 201–208
9.
Cabeza I G , Amador M S , Lopez C A , Gonzalez de Chavez M (2000) Subjective response to antipsychotics in schizophrenic patients: clinical implications and related factors . Schizophrenia Research41(2): 349–355
10.
Carriere P , Bonhomme D , Lemperiere T (2000) Amisulpride has a superior benefit/risk profile to haloperidol in schizophrenia: results of a multicentre, double-blind study. The Amisulpride Study Group . Eur Psychiatry15(5): 321–329
11.
Curran M P , Perry C M (2001) Amisulprid . Drugs61(14): 2123–2150
12.
Dixon L B , Lehman A F , Levine J (1995) Conventional antipsychotic medications for schizophrenia . Schizophrenia Bulletin21(4): 567–577
13.
Dolder C R , Lacro J P , Dunn L B , Jeste D V (2002) Antipsychotic medication adherence: is there a difference between typical and atypical agents?American Journal of Psychiatry159(1): 103–108
14.
Donohoe G , Owens N , O'Donnell C , Burke T , Moore L , Tobin A , O'Callaghan E (2001) Predictors of compliance with neuroleptic medication among inpatients with schizophrenia: a discriminant function analysis . European Psychiatry16(5): 293–298
15.
Fenton W S , Blyler C R , Heinssen R K (1997) Determinants of medication compliance in schizophrenia: empirical and clinical findings . Schizophrenia Bulletin23(4): 637–651
16.
Fleischhacker W W , Meise U , Günther V , Kurz M (1994) Compliance with antipsychotic drug treatment: Influence of side effects . Acta Psychiatrica Scandinavica89(Suppl.): 11–15
17.
Franz M , Lis S , Pluddemann K , Gallhofer B (1997) Conventional versus atypical neuroleptics: subjective quality of life in schizophrenic patients . British Journal of Psychiatry170: 422–425
18.
Garavan J , Browne S , Gervin M , Lane A , Larkin C , O'Callaghan E (1998) Compliance with neuroleptic medication in outpatients with schizophrenia; relationship to subjective response to neuroleptics; attitudes to medication and insight . Comprehensive Psychiatry39(4): 215–219
19.
Haynes R B , Taylor D W , Snow J C , Sackett D L (1979) An annotated and indexed bibliography on compliance with therapeutic and preventive regimens. In Haynes R B , Taylor D W , Sackett D L (eds), Compliance in health care. Johns Hopkins University Press, Baltimore , pp. 337–474
20.
Johnson D A W (1977) Practical considerations in the use of depot neuroleptics for the treatment of schizophrenia . British Journal of Hospital Medicine17: 564–569
21.
Johnson D A W , Freeman W (1973) Drug defaulting by patients on longacting phenothiazines . Psychological Medicine3: 115–119
22.
Kissling W (1991) Guidelines for neuroleptic relapse prevention in schizophrenia. Springer: Berlin .
23.
Kissling W (1992) Ideal and reality of neuroleptic relapse prevention . British Journal of Psychiatry161(Suppl.): 133–139
24.
Lambert M , Graf Schimmelmann B , Haasen C , Naber D (2000) Subjektive Befindlichkeit unter neuroleptischer Therapie: Relevant für die Psychopharmakotherapie psychotischer Patienten?Psychopharmakotherapie9(2): 53–59
25.
Lecrubier Y (2000) Is amisulpride an ‘atypical’ atypical antipsychotic agent?International Clinical Psychopharmacology15 (Suppl. 4): S21–S26
26.
Legangneux E , McEwen J , Wesnes K A , Bergougnan L , Miget N , Canal M , L'Heritier C , Pinquier J L , Rosenzweig P (2000) The acute effects of amisulpride (50mg and 200mg) and haloperidol (2mg) on cognitive function in healthy elderly volunteers . Journal of Psychopharmacology14(2): 164–171
27.
Lin I F , Spiga R , Fortsch W (1979) Insight and adherence to medication in chronic schizophrenics . Journal of Clinical Psychiatry430: 37–39
28.
Linden M (1987) Negative vs. positive Therapieerwartungen und Compliance vs. Non-Compliance . Psychiatrische Praxis14: 33–136
29.
Linden M , Godemann F , Gaebel W , Köpke W , Müller P , Müller-Spahn F , Pietzcker A , Tegeler J (2001) A prospective study of factors influencing adherence to a continuous neuroleptic treatment program in schizophrenia patients during 2 years . Schizophrenia Bulletin27(4): 585–596
30.
Lindström L H (1994) Long-term clinical and social outcome studies in schizophrenia in relation to cognitive and emotional side effects of antipsychotic drugs . Acta Psychiatrica Scandinavica89(Suppl.): 74–76
31.
McEvoy J P , Allison C H , Hogarty G E (1984) Differences in the nature of relapse and subsequent inpatient course between medication-compliant and noncompliant schizophrenic patients . Journal of Nervous and Mental Disease172(7): 412–416
32.
Marder S R (1998) Facilitating compliance with antipsychotic medication . Journal of Clinical Psychiatry59(Suppl. 3): 21–25
33.
Marder S R , Mebane A , Chien C , Winslade W J , Swann E , van Putten T (1983) A comparison of patients who refuse and consent to neuroleptic treatment . American Journal of Psychiatry140(4): 470–472
34.
Marder S R , van Putten T , Mintz J , McKenzie J , Lebell M , Faltico G , May P R A (1984) Costs and doses of two doses of fluphenazine . Archives of General Psychiatry41: 1025–1029
35.
Mehta M M , Hinton E C , Montgomery A J , Bantick R A , Grasby P M (2005) Sulpiride and mnemonic function: effects of a dopamine D2 receptor antagonist on working memory, emotional memory and long-term memory in healthy volunteers . Journal of Psychopharmacology19: 29–38
36.
Merinder L B (2000) Patient education in schizophrenia: a review . Acta Psychiatrica Scandinavica102(2): 98–106
37.
Mojtabai R , Lavelle J , Gibson P J , Sohler N L , Craig T J , Carlson G A , Bromet E J (2002) Gaps in use of antipsychotics after discharge by first-admission patients with schizophrenia, 1989 to 1996 . Psychiatric Services53(3): 337–339
38.
Moore A , Sellwood W , Stirling J (2000) Compliance and psychological reactance in schizophrenia . British Journal of Clinical Psychology39(Pt 3): 287–295
39.
Naber D (1995) A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables . International Clinical Psychopharmacology10: 133–138
40.
Naber D , Karow A (2001) Good tolerability equals good results: the patient's perspective . European Neuropsychopharmacology11(Suppl. 4): 391–396
41.
Naber D , Walther A , Kirchner T , Hayek D , Holzbach R (1994) Subjective effects of neuroleptics predict compliance. In Gaebel W , Awad R (eds), Prediction of neuroleptic treatment outcome in schizophrenia. Concepts and methods. Heidelberg, Springer , pp. 85–98.
42.
Naber D , Moritz S , Lambert M , Rajonk F , Holzbach R , Mass R , Andresen B , Frank P , Rüdiger H , Reinhard M , Burghard A (2001) Improvement of schizophrenic patients' subjective well-being under atypical antipsychotic drugs . Schizophrenia Research50(1–2): 79–88
43.
Oehl M , Hummer M , Fleischhacker W W (2000) Compliance with antipsychotic treatment . Acta Psychiatrica Scandinavica102 (Suppl. 407): 83–86
44.
Olfson M , Mechanic D , Hansell S , Boyer C A , Walkup J , Weiden P J (2000) Predicting medication noncompliance after hospital discharge among patients with schizophrenia . Psychiatric Services51(2): 216–222
45.
Pan P-C , Tantam C (1989) Clinical characteristics, health beliefs and compliance with maintenance treatment: a comparison between regular and irregular attenders at a depot clinic . Acta Psychiatrica Scandinavica79: 564–570
46.
Perkins D O (2002) Predictors of noncompliance in patients with schizophrenia . Journal of Clinical Psychiatry63(12): 1121–1128
47.
Peuskens J (2002) Switching to amisulpride . Current Medical Research and Opinion18(S3): 23–28
48.
Razali M S , Yahya H (1995) Compliance with treatment in schizophrenia: A drug intervention program in a developing country . Acta Psychiatrica Scandinavica91: 331–335
49.
Rossi A , Arduini L , Stratta P , Pallanti S (2000) Subjective experience and subjective response to neuroleptics in schizophrenia . Comprehensive Psychiatry41(6): 446–449
50.
Schwartz D , Wang D (1962) Medication errors made by elderly, chronically ill patient . American Journal of Public Health52: 2018–2029
51.
Soskis D A (1978) Schizophrenic and medical inpatients as informed drug consumers . Archives of General Psychiatry12: 645–647
52.
Tattan T M , Creed F H (2001) Negative symptoms of schizophrenia and compliance with medication . Schizophrenia Bulletin27(1): 149–155
53.
van Putten T (1974) Why do schizophrenic patients refuse to take their drugs?Archives of General Psychiatry31: 67–72
54.
van Putten T , May P R (1978) Subjective response as a predictor of outcome in pharmacotherapy: the consumer has a point . Archives of General Psychiatry35(4): 477–480
55.
van Putten T , Crumpton E , Yale C (1976) Drug refusal in schizophrenia and the wish to be crazy . Archives of General Psychiatry33: 1443–1446
56.
van Putten T , May P R A , Marder S R (1984) Response to antipsychotic medication: The doctor's and the consumer's view . American Journal of Psychiatry141: 16–19
57.
van Putten T , May P R A , Marder S R , Wittmann L A (1981) Subjective response to antipsychotic drugs . Archives of General Psychiatry38: 187–190
58.
Wetzel H , Grunder G , Hillert A , Philipp M , Gattaz W F , Sauer H , Adler G , Schroder J , Rein W , Benkert O (1998) Amisulpride versus flupentixol in schizophrenia with predominantly positive symptomatology – a double-blind controlled study comparing a selective D2-like antagonist to a mixed D1-/D2-like antagonist . The Amisulpride Study Group. Psychopharmacology137(3): 223–232
