Impact of once- versus twice-daily perphenazine dosing on clinical outcomes: An analysis of the CATIE data

Hiroyoshi Takeuchi, Gagan Fervaha, Hiroyuki Uchida, Takefumi Suzuki, Robert R. Bies, David Gronte, Gary Remington

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: The objective of this study was to evaluate the impact of once- versus twice-daily dosing of perphenazine, which has a plasma half-life of 8-12 hours, on clinical outcomes in patients with schizophrenia. Method: Data from phase 1 of the Clinical Antipsychotic Trial of Intervention Effectiveness (CATIE) conducted between January 2001 and December 2004 were used in this post hoc analysis. Patients with schizophrenia (DSM-IV) randomly allocated to treatment with perphenazine were also randomly assigned to once-daily (N = 133) or twice-daily (N = 124) dosing and followed over 18 months. Discontinuation rate and time to discontinuation were used as primary outcomes to compare the 2 groups. The following clinical outcomes were analyzed as secondary measures: efficacy - Positive and Negative Syndrome Scale, Clinical Global Impressions-Severity scale, Calgary Depression Scale for Schizophrenia, and Drug Attitude Inventory and safety/ tolerability - Abnormal Involuntary Movement Scale, Barnes Akathisia Rating Scale, Simpson-Angus Scale, and body weight. Data on treatment-emergent adverse events, concomitant psychotropic medications, and medication adherence (pill count and clinician rating scale) were also analyzed for each group. Results: No significant differences were found in any outcome measures between the once-daily and twice-daily dosing groups, which remained the same when using the mean dose of perphenazine as a covariate. Conclusions: Perphenazine is routinely administered in a divided dosage regimen because of its relatively short plasma half-life. However, the present findings challenge such a strategy, suggesting that once-daily represents a viable treatment option. Results are discussed in the context of more recent evidence that challenges the need for high and continuous dopamine D2 receptor blockade to sustain antipsychotic response.

Original languageEnglish
Pages (from-to)506-511
Number of pages6
JournalJournal of Clinical Psychiatry
Volume75
Issue number5
DOIs
Publication statusPublished - 2014

Fingerprint

Perphenazine
Antipsychotic Agents
Clinical Trials
Schizophrenia
Half-Life
Psychomotor Agitation
Clinical Trials, Phase I
Medication Adherence
Dopamine D2 Receptors
Diagnostic and Statistical Manual of Mental Disorders
Therapeutics
Body Weight
Outcome Assessment (Health Care)
Depression
Safety
Equipment and Supplies
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Arts and Humanities (miscellaneous)

Cite this

Impact of once- versus twice-daily perphenazine dosing on clinical outcomes : An analysis of the CATIE data. / Takeuchi, Hiroyoshi; Fervaha, Gagan; Uchida, Hiroyuki; Suzuki, Takefumi; Bies, Robert R.; Gronte, David; Remington, Gary.

In: Journal of Clinical Psychiatry, Vol. 75, No. 5, 2014, p. 506-511.

Research output: Contribution to journalArticle

Takeuchi, Hiroyoshi ; Fervaha, Gagan ; Uchida, Hiroyuki ; Suzuki, Takefumi ; Bies, Robert R. ; Gronte, David ; Remington, Gary. / Impact of once- versus twice-daily perphenazine dosing on clinical outcomes : An analysis of the CATIE data. In: Journal of Clinical Psychiatry. 2014 ; Vol. 75, No. 5. pp. 506-511.
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