Antipsychotic Trials in Schizophrenia: The CATIE Project by T. Scott Stroup, Jeffrey A. Lieberman

By T. Scott Stroup, Jeffrey A. Lieberman

Antipsychotic drugs are a key remedy for schizophrenia and revenues of antipsychotic medications technique $20 billion in keeping with yr, with fierce advertising among the makers of the medication. The U.S. nationwide Institute of psychological health and wellbeing subsidized the medical Antipsychotic Trials of Intervention Effectiveness (CATIE) venture to supply autonomous information regarding the comparative effectiveness of medicines. CATIE was once the biggest, longest and such a lot complete examine of schizophrenia thus far. carried out below rigorous double-blind stipulations, Antipsychotic Trials in Schizophrenia offers the definitive archival result of this landmark examine. The middle of the publication contains chapters excited about particular results that set the CATIE findings in a much broader context. additionally integrated are chapters at the layout, statistical analyses and implications for researchers, clinicians and coverage makers. Psychiatrists, psychiatric researchers, psychological well-being coverage makers and people operating in pharmaceutical businesses will all locate this to be crucial interpreting.

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Mixed models develop estimates under the assumption that the missing data are correlated in the same way as observed data, or in other words, that the data are missing at random. The mixed model may be fairly robust to some departure from this assumption, as has been shown by simulations of an example where the drop-out rate was 40% [14]. However, the amount of missing data in CATIE was substantial, reaching 74% by 18 months. Results from models based on such a substantial amount of missing data should be viewed with caution.

Patients who entered the study were those with chronic schizophrenia for whom a new medication was needed or for whom a change in medications was an appropriate option. 3). Clinicians prescribed one to four capsules daily, based upon individual patients’ therapeutic response and side effect burden. Once and twice daily medication schedules Quetiapine and ziprasidone required twice daily (BID) dosing, whereas perphenazine, olanzapine, and risperidone could be taken once daily (QD). Because it would deviate from clinical practice patterns to insist on BID dosing in all cases, we sought to minimize the number of patients required to take their medication BID, and still maintain blinding to the extent possible.

There were many tertiary domains, such as compliance, competency to give informed consent, family burden, violence, substance abuse, employment, use of concomitant medications, and the effect of prior antipsychotic treatments. A complete list of tertiary domains need not be specified a priori, as long as each domain was logically independent of others. In general, within the primary and secondary domains, the domain-wise Type I error rate was maintained by identifying one primary analysis of one primary parameter within the domain.

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