{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:33:53Z","timestamp":1789472033342,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"German Federal Ministry for Education and Research","award":["01KG0910"],"award-info":[{"award-number":["01KG0910"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Hypothesis<\/jats:title>\n                  <jats:p>Meta-analyses have shown that the majority of patients with schizophrenia who have not improved after 2 weeks of treatment with an antipsychotic drug are unlikely to fully respond later. We hypothesized that switching to another antipsychotic with a different receptor binding profile is an effective strategy in such a situation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Design<\/jats:title>\n                  <jats:p>In total, 327 inpatients with an acute exacerbation of schizophrenia were randomized to double-blind treatment with either olanzapine (5\u201320 mg\/day) or amisulpride (200\u2013800 mg\/day). Those patients who had not reached at least 25% Positive-and-Negative-Syndrome-Scale (PANSS) total score reduction from baseline after 2 weeks (the \u201cnon-improvers\u201d) were rerandomized double-blind to either staying on the same compound (\u201cstayers\u201d) or to switching to the other antipsychotic (\u201cswitchers\u201d) for another 6 weeks. The primary outcome was the difference in the number of patients in symptomatic remission between the combined \u201cswitchers\u201d and the \u201cstayers\u201d after 8 weeks of treatment, analyzed by logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Results<\/jats:title>\n                  <jats:p>A total of 142 nonimprovers were rerandomized at week two. 25 (45.5 %) of the \u2018stayers' compared to 41 (68.3 %) of the \u201cswitchers\u201d reached remission at endpoint (p = .006). Differences in secondary efficacy outcomes were not significant, except for the PANSS negative subscore and the Clinical-Global-Impression-Scale. \u201cSwitchers\u201d and \u201cstayers\u201d did not differ in safety outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Switching \u201cnon-improvers\u201d from amisulpride to olanzapine or vice-versa increased remission rates and was safe. The superiority in the primary outcome was, however, not paralleled by significant differences in most secondary efficacy outcomes and the effect was only apparent at the last visit making replications of longer duration necessary.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/schbul\/sbac068","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T17:38:44Z","timestamp":1658338724000},"page":"1273-1283","source":"Crossref","is-referenced-by-count":13,"title":["Changing the Antipsychotic in Early Nonimprovers to Amisulpride or Olanzapine: Randomized, Double-Blind Trial in Patients With Schizophrenia"],"prefix":"10.1093","volume":"48","author":[{"given":"Stephan","family":"Heres","sequence":"first","affiliation":[{"name":"Klinik Nord des Isar-Amper-Klinikums M\u00fcnchen Ost K\u00f6lner Platz 1 , Haus 7 80804 Munich , Germany"},{"name":"Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Cordes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, LVR-Clinic D\u00fcsseldorf, Medical Faculty, Heinrich-Heine-University , Duesseldorf NW , Germany"},{"name":"Department of Psychiatry and Psychotherapy, Kaiserswerther Diakonie, Florence Nightingale Hospital , D\u00fcsseldorf NW , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Feyerabend","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, LVR-Clinic D\u00fcsseldorf, Medical Faculty, Heinrich-Heine-University , Duesseldorf NW , Germany"},{"name":"Department of Psychiatry and Psychotherapy, Kaiserswerther Diakonie, Florence Nightingale Hospital , D\u00fcsseldorf NW , 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