SAN FRANCISCO -- Early episode schizophrenia responds better to aripiprazole than to haloperidol on measures of social engagement, a post hoc analysis of 460 patients presented in a poster session at the annual meeting of the American Psychiatric Association shows.
It has long been observed that most negative symptoms show little change with antipsychotic treatment in schizophrenia. Other studies have suggested that relatively small improvements in these symptoms may be correlated with better functional recovery.
"Improvement in social function may reduce the risk of functional deterioration in patients with early episode schizophrenia," wrote Ross A. Baker, Ph.D., of Bristol-Myers Squibb Co., and his coauthors. The investigators defined "early episode" schizophrenia as that involving patients aged 40 years or younger who had been diagnosed no more than 5 years previously. The analysis combined data from two 52-week studies that compared 20-30 mg/day aripiprazole (Abilify) with 5-10 mg/day of haloperidol (Haldol)
Investigators used two subscales of the Positive and Negative Syndrome Scale (PANSS)--the prosocial subscale and the modified prosocial subscale--as their measures of social engagement.
Patients demonstrated significantly greater improvement with aripiprazole than with haloperidol on both sub-scales as early as week 18 and continuing to week 52. For example, the mean decline in Prosocial scores was 4.75 points in patients taking aripiprazole. compared with 3.78 points in patients taking haloperidol. On the modified Prosocial subscale, the mean decline was 3.16 points for patients taking aripiprazole and 2.28 points in patients taking haloperidol.
There were far fewer discontinuations because of adverse events among the patients taking aripiprazole, 11% vs. 28%, the investigators wrote. The most common adverse event with aripiprazole was insomnia (18%); the most common adverse event with haloperidol was extrapyramidal syndrome.
The study was funded by Bristol-Myers Squibb and Otsuka Pharmaceutical Co.




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