Publication:

A randomized prospective comparative study of efficacy of asenapine, iloperidone and zotepine in patients with psychosis

Background Antipsychotic drugs constitute the mainstay in the treatment of schizophrenia and other psychotic disorders. For these medications to be maximally beneficial, they must be efficacious, with an acceptable side effect profile and be taken as prescribed. The objective of the study was to compare the efficacy of iloperidone, asenapine and zotepinein subjects with psychotic disorders.

Methods Randomized prospective study was conducted in the Department of Psychiatry of a tertiary care hospital, at Mysore, India. Sixty Patients who met the criteria for acute psychosis and schizophrenia according to ICD 10 were recruited. Atypical antipsychotics-asenapine, iloperidone and zotepine were administered and their efficacy was monitored by brief psychiatric rating scale (BPRS), which was administered on day one, week 1, week 3 and week 6.

Results Out of 60 recruited subjects 31 (51.7%) completed all four visits of the study. Iloperidone and asenapine showed significant improvement in efficacy than zotepine at week 6. Among the total dropouts 55.2% subjects didn’t come for follow-up and 44.8% were dropped due to development of side effects.

Conclusions In patients with acute psychosis and schizophrenia, iloperidone appears more effective and tolerated than the other two. Asenapine was effective but less tolerated and zotepine was less efficacious and produced poor response. Asenapine and zotepine have more dropouts and showed few uncommon extrapyramidal side effects.