A randomized, flexible-dose, quasi-naturalistic comparison of quetiapine, risperidone, and olanzapine in the short-term treatment of schizophrenia: The QUERISOLA trial

Sacchetti, Emilio; Valsecchi, Paolo; Parrinello, Giovanni; for the QUERISOLA Group,

doi:10.1016/j.schres.2007.09.011

« Previous Next »Schizophrenia Research
Volume 98, Issue 1 , Pages 55-65, January 2008

A randomized, flexible-dose, quasi-naturalistic comparison of quetiapine, risperidone, and olanzapine in the short-term treatment of schizophrenia: The QUERISOLA trial

Emilio Sacchetti
- Department of Psychiatry, Brescia University School of Medicine, Brescia, Italy
- University Psychiatric Unit, Brescia University School of Medicine and Brescia Spedali Civili, Brescia, Italy
- Department of Mental Health, Brescia Spedali Civili, Brescia, Italy
- Centre of Behavioural and Neurodegenerative Disorders, Brescia University and EULO, Brescia, Italy
- Corresponding author. University Psychiatric Unit, Brescia Spedali Civili, Piazza Spedali Civili, 1, 25123 Brescia, Italy. Tel.: +39 030 3995233/381749; fax: +39 030 3384089.
Paolo Valsecchi
- University Psychiatric Unit, Brescia University School of Medicine and Brescia Spedali Civili, Brescia, Italy
- Department of Mental Health, Brescia Spedali Civili, Brescia, Italy
Giovanni Parrinello
- Department of Biomedical Sciences and Biotechnologies, Section of Medical Statistics and Biometry, Brescia University School of Medicine, Brescia, Italy
for the QUERISOLA Group

Received 6 June 2007; received in revised form 10 September 2007; accepted 12 September 2007. published online 16 October 2007.

Abstract

This was a randomized, flexible-dose, rater-blind, parallel-group, quasi-naturalistic trial comparing the efficacy, safety, and tolerability of quetiapine, risperidone, and olanzapine in patients with schizophrenia hospitalized for severe psychotic symptoms. Seventy-five patients were randomized to quetiapine (n=25), risperidone (n=25), or olanzapine (n=25). Mean doses at Week 8 were: 590.0 mg/day quetiapine; 5.1 mg/day risperidone; 15.1 mg/day olanzapine. Four quetiapine, five risperidone, and five olanzapine patients discontinued prior to Week 8. There were no significant differences between groups in the primary efficacy measures of improvement from baseline in Positive and Negative Syndrome Scale (PANSS) total score at Week 8 in the per protocol (PP) population and the number of completers who experienced ≥ 40% improvement on the same scale. PP and intent-to-treat analyses showed significant improvement from baseline in each component of a PANSS-derived battery, without significant differences between treatments. No quetiapine patients, one risperidone, and four olanzapine patients reported an adverse event (AE) of moderate intensity; no severe AEs were reported. A linear mixed model for repeated measures showed an effect of treatment on body weight, with significant differences favoring quetiapine over risperidone and olanzapine.

Simpson–Angus Scale scores were significantly worse with risperidone compared with both olanzapine and quetiapine at Week 3 and compared with quetiapine thereafter. Use of concomitant medications for anxiety or tension was significantly less frequent with quetiapine. In conclusion, quetiapine, risperidone, and olanzapine have similar efficacy in schizophrenia, but there are drug-specific differences for some AEs and in the use of concomitant medication that differentiate these agents.

Keywords: Schizophrenia, Quetiapine, Risperidone, Olanzapine, Antipsychotics, Randomized controlled trial