Korean Journal of Schizophrenia Research (대한조현병학회지)

Korean Society for Schizophrenia Research (대한조현병학회)
권호 표지
DOI QR코드

DOI QR Code

Pseudo-Resistant Schizophrenia: Non-Adherence to Treatment

치료 위저항성 조현병: 치료 비순응을 중심으로

  • Kim, Hyerim (Department of Psychiatry, School of Medicine, Kyungpook National University) ;
  • Lee, Seung Jae (Department of Psychiatry, School of Medicine, Kyungpook National University)
  • 김혜림 (경북대학교 의과대학 정신건강의학교실) ;
  • 이승재 (경북대학교 의과대학 정신건강의학교실)
  • Received : 2020.10.09
  • Accepted : 2020.10.12
  • Published : 2020.10.30
⟨ Previous Next ⟩

Abstract

Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to exclude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacokinetic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or pharmacokinetic factors, and present methods to enhance drug adherence.

Keywords

References

  1. Howes OD, McCutcheon R, Agid O, de Bartolomeis A, van Beveren NJ, Birnbaum ML, et al. Treatment-resistant schizophrenia: treatment response and resistance in psychosis (TRRIP) working group consensus guidelines on diagnosis and terminology. Am J Psychiatry 2017;174:216-229. https://doi.org/10.1176/appi.ajp.2016.16050503
  2. Siskind D, Siskind V, Kisely S. Clozapine response rates among people with treatment-resistant schizophrenia: data from a systematic review and meta-analysis. Can J Psychiatry 2017;62:772-777. https://doi.org/10.1177/0706743717718167
  3. Kane JM, Agid O, Baldwin ML, Howes O, Lindenmayer JP, Marder S, et al. Clinical guidance on the identification and management of treatment-resistant schizophrenia. J Clin Psychiatry 2019;80:18com12123.
  4. Kinon BJ. The group of treatment resistant schizophrenias. heterogeneity in treatment resistant schizophrenia (TRS). Front Psychiatry 2018;9:757. https://doi.org/10.3389/fpsyt.2018.00757
  5. Potkin SG, Kane JM, Correll CU, Lindenmayer JP, Agid O, Marder SR, et al. The neurobiology of treatment-resistant schizophrenia: paths to antipsychotic resistance and a roadmap for future research. NPJ Schizophr 2020;6:1. https://doi.org/10.1038/s41537-019-0090-z
  6. Dold M, Leucht S. Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective. Evid Based Ment Health 2014;17:33-37. https://doi.org/10.1136/eb-2014-101813
  7. Lee JS, Yun JY, Kang SH, Lee SJ, Choi JH, Nam B, et al. Korean Medication Algorithm for Schizophrenia 2019, Second Revision: Treatment of Psychotic Symptoms. Clin Psychopharmacol Neurosci 2020;18:386-394. https://doi.org/10.9758/cpn.2020.18.3.386
  8. Czobor P, Van Dorn RA, Citrome L, Kahn RS, Fleischhacker WW, Volavka J. Treatment adherence in schizophrenia: a patient-level meta-analysis of combined CATIE and EUFEST studies. Eur Neuropsychopharmacol 2015;25:1158-1166. https://doi.org/10.1016/j.euroneuro.2015.04.003
  9. Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics: differential risk and clinical implications. CNS Drugs 2007;21:911-936. https://doi.org/10.2165/00023210-200721110-00004
  10. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005;353:1209-1223. https://doi.org/10.1056/NEJMoa051688
  11. Lacro JP, Dunn LB, Dolder CR, Leckband SG, Jeste DV. Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 2002;63:892-909. https://doi.org/10.4088/JCP.v63n1007
  12. Sajatovic M, Valenstein M, Blow FC, Ganoczy D, Ignacio RV. Treatment adherence with antipsychotic medications in bipolar disorder. Bipolar Disord 2006;8:232-241. https://doi.org/10.1111/j.1399-5618.2006.00314.x
  13. Valenstein M, Ganoczy D, McCarthy JF, Myra Kim H, Lee TA, Blow FC. Antipsychotic adherence over time among patients receiving treatment for schizophrenia: a retrospective review. J Clin Psychiatry 2006;67:1542-1550. https://doi.org/10.4088/JCP.v67n1008
  14. Byerly M, Fisher R, Whatley K, Holland R, Varghese F, Carmody T, et al. A comparison of electronic monitoring vs. clinician rating of antipsychotic adherence in outpatients with schizophrenia. Psychiatry Res 2005;133:129-133. https://doi.org/10.1016/j.psychres.2004.11.002
  15. Bozzatello P, Bellino S, Rocca P. Predictive factors of treatment resistance in first episode of psychosis: a systematic review. Front Psychiatry 2019;10:67. https://doi.org/10.3389/fpsyt.2019.00067
  16. McCutcheon R, Beck K, D'Ambrosio E, Donocik J, Gobjila C, Jauhar S, et al. Antipsychotic plasma levels in the assessment of poor treatment response in schizophrenia. Acta Psychiatr Scand 2018;137:39-46. https://doi.org/10.1111/acps.12825
  17. Horvitz-Lennon M, Mattke S, Predmore Z, Howes OD. The role of antipsychotic plasma levels in the treatment of schizophrenia. Am J Psychiatry 2017;174:421-426. https://doi.org/10.1176/appi.ajp.2016.16040402
  18. De Leon J. Atypical antipsychotic dosing: the effect of smoking and caffeine. Psychiatr Serv 2004;55:491-493. https://doi.org/10.1176/appi.ps.55.5.491
  19. Kennedy WK, Jann MW, Kutscher EC. Clinically significant drug interactions with atypical antipsychotics. CNS Drugs 2013;27:1021-1048. https://doi.org/10.1007/s40263-013-0114-6
  20. Flockhart D. Drug interactions: cytochrome P450 drug interaction table. Indiana University School of Medicine 2007 [cited 2020 Oct 8]. Available from: http://medicine.iupui.edu/clinpharm/ddis/table.aspx
  21. Kitada M. Genetic polymorphism of cytochrome P450 enzymes in Asian populations: focus on CYP2D6. Int J Clin Pharmacol Res 2003;23:31-35.
  22. Bernard S, Neville KA, Nguyen AT, Flockhart DA. Interethnic differences in genetic polymorphisms of CYP2D6 in the U.S. population: clinical implications. Oncologist 2006;11:126-135. https://doi.org/10.1634/theoncologist.11-2-126
  23. Lee SY, Sohn KM, Ryu JY, Yoon YR, Shin JG, Kim JW. Sequence-based CYP2D6 genotyping in the Korean population. Ther Drug Monit 2006;28:382-387. https://doi.org/10.1097/01.ftd.0000211823.80854.db
  24. Hogan TP, Awad A, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med 1983;13:177-183. https://doi.org/10.1017/S0033291700050182
  25. Yoon BH, Bahk WM, Lee KU, Hong CH, Ahn JK, Kim MK. Psychometric properties of Korean version of drug attitude inventory (KDAI-10). Korean J Psychopharmacol 2005;16:480-487.
  26. Thompson K, Kulkarni J, Sergejew A. Reliability and validity of a new medication adherence rating scale (MARS) for the psychoses. Schizophr Res 2000;42:241-247. https://doi.org/10.1016/S0920-9964(99)00130-9
  27. Chang JG, Roh D, Kim CH. The reliability and validity of the Korean version of medication adherence rating scale. Korean J Psychopharmacol 2015;26:43-49.
  28. Hemingway S. Medicines adherence-involving patients in decisions about prescribed medicines and supporting adherence: NICE clinical guideline 76. Ment Health Nurs 2009;29:10.
  29. Wilder CM, Elbogen EB, Moser LL, Swanson JW, Swartz MS. Medication preferences and adherence among individuals with severe mental illness and psychiatric advance directives. Psychiatr Serv 2010;61:380-385. https://doi.org/10.1176/appi.ps.61.4.380
  30. Pfeiffer PN, Ganoczy D, Valenstein M. Dosing frequency and adherence to antipsychotic medications. Psychiatr Serv 2008;59:1207-1210. https://doi.org/10.1176/ps.2008.59.10.1207
  31. Guy W. ECDEU Assessment Manual for Psychopharmacology, revised 1976 (Abnormal Involuntary Movement Scale [AIMS]) Rockville Maryland: National Institute of Mental Health;1976. p.534-537.
  32. Waddell L, Taylor M. A new self-rating scale for detecting atypical or second-generation antipsychotic side effects. J Psychopharmacol 2008;22:238-243. https://doi.org/10.1177/0269881107087976
  33. Day J, Wood G, Dewey M, Bentall R. Liverpool university neuroleptic side effect rating scale. Br J Psychiatry 1995;166:650-653. https://doi.org/10.1192/bjp.166.5.650
  34. Jung HY, Kim JH, Ahn YM, Kim SC, Hwang SS, Kim YS. Liverpool university neuroleptic side-effect rating scale (LUNSERS) as a subjective measure of drug-induced parkinsonism and akathisia. Hum Psychopharmacol 2005;20:41-45. https://doi.org/10.1002/hup.655
  35. Xia J, Merinder LB, Belgamwar MR. Psychoeducation for schizophrenia. Cochrane Database Syst Rev;2011.
  36. Hasan AA, Callaghan P, Lymn JS. Evaluation of the impact of a psycho-educational intervention for people diagnosed with schizophrenia and their primary caregivers in Jordan: a randomized controlled trial. BMC Psychiatry 2015;15:72. https://doi.org/10.1186/s12888-015-0444-7
  37. Alhadidi MM, Abdullah KL, Yoong TL, Hadid LA, Danaee M. A systematic review of randomized controlled trials of psychoeducation interventions for patients diagnosed with schizophrenia. Int J Soc Psychiatry 2020;66:542-552. https://doi.org/10.1177/0020764020919475
  38. Boczkowski JA, Zeichner A, DeSanto N. Neuroleptic compliance among chronic schizophrenic outpatients: an intervention outcome report. J Consult Clin Psychol 1985;53:666. https://doi.org/10.1037/0022-006X.53.5.666
  39. Razali SM, Hasanah CI, Khan A, Subramaniam M. Psychosocial interventions for schizophrenia. J Ment Health 2000;9:283-289. https://doi.org/10.1080/713680246
  40. Turkington D, Kingdon D, Weiden PJ. Cognitive behavior therapy for schizophrenia. Am J Psychiatry 2006;163:365-373. https://doi.org/10.1176/appi.ajp.163.3.365
  41. Cramer JA, Rosenheck R. Enhancing medication compliance for people with serious mental illness. J Nerv Ment Dis 1999;187:53-55. https://doi.org/10.1097/00005053-199901000-00009
  42. Eckman TA, Wirshing WC, Marder SR, Liberman RP, Johnston-Cronk K, Zimmermann K, et al. Technique for training schizophrenic patients in illness self-management: a controlled trial. Am J Psychiatry 1992;149:1549-1555. https://doi.org/10.1176/ajp.149.11.1549
  43. Kemp R, Kirov G, Everitt B, Hayward P, David A. Randomised controlled trial of compliance therapy. 18-month follow-up. Br J Psychiatry 1998;172:413-419. https://doi.org/10.1192/bjp.172.5.413
  44. Velligan DI, Bow-Thomas CC, Huntzinger C, Ritch J, Ledbetter N, Prihoda TJ, et al. Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatients with schizophrenia. Am J Psychiatry 2000;157:1317-1328. https://doi.org/10.1176/appi.ajp.157.8.1317
  45. Velligan DI, Diamond PM, Maples NJ, Mintz J, Li X, Glahn DC, et al. Comparing the efficacy of interventions that use environmental supports to improve outcomes in patients with schizophrenia. Schizophr Res 2008;102:312-319. https://doi.org/10.1016/j.schres.2008.02.005
  46. Subotnik KL, Casaus LR, Ventura J, Luo JS, Hellemann GS, Gretchen-Doorly D, et al. Long-acting injectable risperidone for relapse prevention and control of breakthrough symptoms after a recent first episode of schizophrenia. A randomized clinical trial. JAMA Psychiatry 2015;72:822-829. https://doi.org/10.1001/jamapsychiatry.2015.0270
  47. Kane JM, Correll CU. Optimizing treatment choices to improve adherence and outcomes in schizophrenia. J Clin Psychiatry 2019;80:IN18031AH1C.
  48. Tiihonen J, Mittendorfer-Rutz E, Majak M, Mehtala J, Hoti F, Jedenius E, et al. Real-world effectiveness of antipsychotic treatments in a nationwide cohort of 29823 patients with schizophrenia. JAMA Psychiatry 2017;74:686-693. https://doi.org/10.1001/jamapsychiatry.2017.1322
  49. Gibson TB, Jing Y, Kim E, Bagalman E, Wang S, Whitehead R, et al. Cost-sharing effects on adherence and persistence for second-generation antipsychotics in commercially insured patients. Manag Care 2010;19:40-47.
  50. Priebe S, Yeeles K, Bremner S, Lauber C, Eldridge S, Ashby D, et al. Effectiveness of financial incentives to improve adherence to maintenance treatment with antipsychotics: cluster randomised controlled trial. BMJ 2013;347:f5847. https://doi.org/10.1136/bmj.f5847
  51. Burton A, Marougka S, Priebe S. Do financial incentives increase treatment adherence in people with severe mental illness? a systematic review. Epidemiol Psichiatr Soc 2010;19:233-242. https://doi.org/10.1017/S1121189X00001160
  52. Schierenberg A, van Amsterdam J, van den Brink W, Goudriaan AE. Efficacy of contingency management for cocaine dependence treatment: a review of the evidence. Curr Drug Abuse Rev 2012;5:320-331. https://doi.org/10.2174/1874473711205040006
  53. Heo JU, Kim DW, Oh ST, Choi WJ, Park J. Clinical characteristics, drug adherence to antipsychotics and medical use trends in patients first diagnosed with psychotic disorder: a preliminary study. Kor J Schizophr Res 2019;22:35-50.