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ObjectivesThis Schizophrenia Outcome Survey compared medical costs, psychopathology and adverse events in outpatients for 2 years following hospitalisation for an acute schizophrenic episode.MethodsAdults stabilised with haloperidol, olanzapine or risperidone entered this observational study ≤1 month after discharge and were assessed at baseline, 3, 6, 12, 18 and 24 months using Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Global Assessment of Functioning and adverse events reporting.ResultsAmong 323 patients (haloperidol 32, olanzapine 149, risperidone 142), baseline characteristics were similar in the olanzapine and risperidone groups, except for more first episodes in the risperidone group (p = 0.01). Haloperidol patients were more often single and institutionalised, less educated, had more residual schizophrenia, were longer hospitalised in the previous year, took more corrective and psychotropic drugs and had more extrapyramidal symptoms (EPS) and gynaecomastia (all significantly). Sixty-eight percent of patients completed a 2-year follow-up. In all groups, CGI and GAF improved during the first 3 months (both p < 0.0001) while BPRS deteriorated in the first year (all within group changes p < 0.05, between group changes NS) before it stabilised. There were no significant differences in hospitalisations and no change in social profile. At the last visit, 66% of haloperidol (p < 0.01), 35% of olanzapine (NS) and 39% (NS) of risperidone patients had ≥1 EPS; 69% (p < 0.013), 40 and 44%, respectively, had ≥1 sexual problem (NS). Mean weight gain was 0.4 (NS), 2.6 (p < 0.05) and 2.6 kg (p < 0.05), respectively.ConclusionsIn this naturalistic study, treatment allocation might have introduced a bias in the interpretation of efficiency results, but olanzapine and risperidone caused less EPS than haloperidol during 2 years of outpatient follow-up.

Objective:SOS compared during 2 years medical costs in Belgian out-patients with schizophrenia.Methods:Patients older than 18 and stabilized with haloperidol(H), olanzapine(O) or risperidone(R) monotherapy entered this observational study at discharge from the hospital.Results:Of 323 patients included, 68% (219/323) completed the study (H59% (19/32), O66% (99/149), R71% (101/142)). In the R group were more first episode patients (H6%, O17%, R27%). H patients were more chronic with more previous hospitalizations.Treatment continuation (no drop out, without medication change or addition) was 31%(H), 50%(O) and 43%(R). The mean dosages were H 8.9 (±9.6), O 14 (±6) and R 4.2 (±1.9) mg/day. Two years medical costs were H 30484 (± 36332), O 20897 (± 27863), R 20916 (± 31776) (NS)The CGI improved during the first 3 months and then remained stable. The percentage of patients with at least 1 EPS at the last visit was: H66%, O35% and R39% (p=0.005) and at least 1 sexual/reproductive problem was H69%, O40%, R44% (p=0.013). Weight gain was H 0.53 ± 5.0, O 3.3 ± 8.3 and R 3.2 ± 8.4 kg.Conclusion:Even in this group of stabilized patients, treatment continuation was poor: in only 1 out of 3 haloperidol patients, treatment was not changed during the 2 years follow up. The fewest treatment change was in the olanzapine group (1 out of 2). Treatment cost was not significantly higher in the haloperidol group and similar in olanzapine and risperidone group as hospitalization was the main cost driver.