Efficacy of Antipsychotic Drugs Against Hostility in the European First-Episode Schizophrenia Trial (EUFEST)
Abstract
Our objective was to compare the effects of haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on hostility in first-episode schizophrenia, schizoaffective disorder, or schizophreniform disorder. We used the data acquired in the European First-Episode Schizophrenia Trial, conducted in 14 countries in 498 patients.
The subjects joined the study as inpatients and continued with follow-up. The Positive and Negative Syndrome Scale (PANSS) was administered at baseline and at 1, 3, 6, 9, and 12 months after randomization.
We analyzed the scores on the PANSS hostility item in a subset of 302 patients showing at least minimal hostility (a score } 1) at baseline. We hypothesized (1) that the treatments would differ in their efficacy for hostility and (2) that olanzapine would be superior to haloperidol.
The primary analysis of hostility indicated an effect of differences between treatments (F(4,889) = 4.02, P = .0031). Post hoc treatment-group contrasts for hostility change showed that, at months 1 and 3, olanzapine was significantly superior (P { .05) to haloperidol, quetiapine, and amisulpride in reducing hostility.
Both hypotheses were supported.