Reasons for continuing or discontinuing olanzapine in the treatment of schizophrenia from the perspectives of patients and clinicians

Figures & data

Table 1 Select items from the reasons for antipsychotic discontinuation/continuation

Reasons for discontinuation This medication did not sufficiently improve positive symptoms (eg, hallucinations, delusions) The patient has not formed a therapeutic alliance or connection with members of the treatment team This medication did not sufficiently improve negative symptoms (eg, flat affect, lack of motivation) Adverse effects (specified) The medication has serious safety issues that are dangerous and potentially life-threatening for this patient (eg, seizures, heart arrhythmia) Potential interactions with another drug prescribed for this patient This medication did not sufficiently improve mood (eg, depression) This medication did not sufficiently improve cognition (eg, planning, attention) This medication did not sufficiently improve functional status (eg, self-care activities of daily living or work) Patient believes medication is no longer necessary Cost of the medication Nonadherence with medication Patient wishes to try another medication Other, specify Reasons for continuation Benefits for negative symptoms (eg, flat affect, lack of motivation) Benefits for positive symptoms (eg, hallucinations, delusions) Benefits for mood (eg, depression) Medication has no serious safety issues that are dangerous and potentially life-threatening for this patient (eg, seizures, heart arrhythmia) The patient has formed a therapeutic alliance or connection with members of the treatment team Financial cost of medication The patient’s insurance adequately covers this medication Benefits for cognition (eg, planning, attention, memory) Benefits for functional status (eg, self-care activities of daily living, or work) Social support (eg, friends or family support the patient in taking this medication) Patient perceptions of improvement (eg, the patient believes he/she is now “better” and wants to continue taking the medication) The patient has already tried other antipsychotics that have not been as effective and/or tolerable Other, specify

Table 2 Baseline characteristics of 191 study patients with Reasons for Antipsychotic Discontinuation/Continuation (RAD-I [patient]) or RAD-Q [clinician]) data

Age (years, mean, SD)	38.6 (±12.0)
Gender
Female	76 (39.8%)
Male	115 (60.2%)
Ethnicity/race
Caucasian (n, %)	84 (44.0%)
African descent (n, %)	14 (7.3%)
East Asian (n, %)	38 (19.9%)
Hispanic (n, %)	50 (26.2%)
Native American (n, %)	1 (0.5%)
West Asian	4 (2.1%)
MADRS total (mean, SD)	14.3 (9.8)
BPRS total score (mean, SD)	47.0 (14.2)
BPRS positive score (mean, SD)	12.3 (5.5)
CGI-S (mean, SD)	4.0 (1.1)
EQ-5D (mean, SD)
US Population-Based Index score	0.7 (0.2)
Visual Analog Scale Health State score	62.1 (24.3)
Weight (kg, mean, SD)	77.6 (16.7)
Body mass index (mean, SD)	27.1 (4.7)

Abbreviations: BPRS, Brief Psychiatric Rating Scale; CGI-S, Clinical Global Impression-Severity; EQ-5D, European Quality of Life-5 Dimensions; MADRS, Montgomery-Åsberg Depression Rating Scale; SD, standard deviation.

Figure 1 Primary reasons for continuing on olanzapine (n = 69 patients; n = 58 clinicians).

Figure 2 Primary reasons for discontinuing olanzapine (discontinuation after visit 2; n = 24 patients; n = 23 clinicians).

Figure 3 Primary reasons for discontinuing the drug used prior to study start (n = 170 patients; n = 173 clinicians).