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Functional recovery results from the risperidone long-acting injectable versus quetiapine relapse prevention trial (ConstaTRE)

  • Frédéric Rouillon (a1), Lars Eriksson (a2), Benjaminas Burba (a3), Jiri Raboch (a4), Georgios Kaprinis (a5) and Andreas Schreiner (a6)...

ConstaTRE is an open-label, randomised, controlled, relapse prevention trial in patients with stable schizophrenia or schizoaffective disorder switched to risperidone long-acting injectable (RLAI) or oral quetiapine, and was designed to test the hypothesis that injectable antipsychotic treatment with risperidone would be more effective than oral therapy with quetiapine. Here we report the functional recovery results from the ConstaTRE trial.


Clinically stable adults previously treated with oral risperidone, olanzapine, or oral first-generation antipsychotics were randomised to RLAI or quetiapine for 24 months. Functional recovery was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS) and two quality-of-life (QoL) measures [Medical Outcomes Survey Short Form-12 (SF-12) and Schizophrenia Quality-of-Life Scale Revision 4 (SQLS-R4)].


A total of 666 patients were randomised and treated with RLAI (n = 329) or quetiapine (n = 337). Relapse occurred in 16.5% RLAI and 31.3% quetiapine patients. Significant improvements in SOFAS, SF-12, and SQLS-R4 scores were observed from baseline to month 24 with both RLAI and quetiapine. At months 6, and 12, and endpoint, improvement in SOFAS score was significantly greater for RLAI than quetiapine (p < 0.05).


Among patients with stable schizophrenia or schizoaffective disorder, the likelihood of functional recovery appears to be higher in those switching to RLAI than to quetiapine, although improvements in functional status and QoL were observed with both treatments.

Corresponding author
Dr. Frédéric Rouillon, Department of Adult Psychiatry and INSERM Center 894, Sainte Anne Hospital, University of Paris Descartes, 1 Rue Cabanis, Paris 75674, France. Tel: +33 1 45 65 7731; Fax: +33 1 46 65 8943; E-mail: f.rouillon
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1.Schooler, NR. Relapse prevention and recovery in the treatment of schizophrenia. J Clin Psychiatry 2006;67(Suppl. 5):1923.
2.Davidson, L, Schmutte, T, Dinzeo, T, Andres-Hyman, R. Remission and recovery in schizophrenia: practitioner and patient perspectives. Schizophr Bull 2008;34:58.
3.McEvoy, JP. Functional outcomes in schizophrenia. J Clin Psychiatry 2008;69(Suppl. 3):2024.
4.Robinson, DG, Woerner, MG, McMeniman, M, Mendelowitz, A, Bilder, RM. Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 2004;161:473479.
5.San, L, Ciudad, A, Alvarez, E, Bobes, J, Gilaberte, I. Symptomatic remission and social/vocational functioning in outpatients with schizophrenia: prevalence and associations in a cross-sectional study. Eur Psychiatry 2007;22:490498.
6.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn.Washington, DC: American Psychiatric Association, 1994.
7.Schooler, NR, Hogarty, GE, Weissman, MM. Social Adjustment Scale II (SAS). In: Hargreaves WP, Attkisson CC and Sorenson JE, editors. Resource Materials for Community Health Program Evaluations, 2nd edn, Publication ADM 79-328. Rockville, MD: US Department of Health, Education and Welfare, 1979. p. 290302.
8.Dunayevich, E, Ascher-Svanum, H, Zhao, Fet al. Longer time to antipsychotic treatment discontinuation for any cause is associated with better functional outcomes for patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder. J Clin Psychiatry 2007;68:11631171.
9.Rosa, MA, Marcolin, MA, Elkis, H. Evaluation of the factors interfering with drug treatment compliance among Brazilian patients with schizophrenia. Rev Bras Psiquiatr 2005;27:178184.
10.Leucht, S, Heres, S. Epidemiology, clinical consequences, and psychosocial treatment of nonadherence in schizophrenia. J Clin Psychiatry 2006;67(Suppl. 5):38.
11.Yamada, K, Watanabe, K, Nemoto, Net al. Prediction of medication noncompliance in outpatients with schizophrenia: 2-year follow-up study. Psychiatry Res 2006;141:6169.
12.Dolder, CR, Lacro, JP, Dunn, LB, Jeste, DV. Antipsychotic medication adherence: is there a difference between typical and atypical agents? Am J Psychiatry 2002;159:103108.
13.Kane, JM. Treatment adherence and long-term outcomes. CNS Spectr 2007;12(Suppl. 17):2126.
14.Linden, M, Godemann, F. The differentiation between “lack of insight” and “dysfunctional health beliefs” in schizophrenia. Psychopathology 2007;40:236241.
15.Löffler, W, Kilian, R, Toumi, M, Angermeyer, MC. Schizophrenic patients’ subjective reasons for compliance and noncompliance with neuroleptic treatment. Pharmacopsychiatry 2003;36:105112.
16.Kane, JM. Review of treatments that can ameliorate nonadherence in patients with schizophrenia. J Clin Psychiatry 2006;67(Suppl. 5):914.
17.Schooler, NR. Relapse and rehospitalization: comparing oral and depot antipsychotics. J Clin Psychiatry 2003;64(Suppl. 16):1417.
18.Gaebel, W, Schreiner, A, Bergmans, Pet al. Relapse prevention in schizophrenia and schizoaffective disorder with risperidone long-acting injectable versus quetiapine: results of a long-term, open-label, randomized clinical trial. Neuropsychopharmacology 2010;35:23672377. Arce Cordón, R, Eding, E, Marques-Teixeira, J, Milanova, V, Rancans, E, Schreiner, A. Descriptive analyses of the aripiprazole arm in the risperidone long-acting injectable versus quetiapine relapse prevention trial (ConstaTRE). Eur Arch Psychiatry Clin Neurosci 2012;262:139149.
20.Csernansky, JG, Mahmoud, R, Brenner, R, Risperidone-USA-79 Study Group. A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. N Engl J Med 2002;346:1622.
21.Peuskens, J, Trivedi, J, Malyarov, Set al. Prevention of schizophrenia relapse with extended release quetiapine fumarate dosed once daily: a randomized, placebo-controlled trial in clinically stable patients. Psychiatry (Edgmont) 2007;4:3450.
22.Macfadden, W, Ma, YW, Thomas Haskins, J, Bossie, CA, Alphs, L. A prospective study comparing the long-term effectiveness of injectable risperidone long-acting therapy and oral aripiprazole in patients with schizophrenia. Psychiatry (Edgmont) 2010;7:2331.
23.Hough, D, Gopal, S, Vijapurkar, U, Lim, P, Morozova, M, Eerdekens, M. Paliperidone palmitate maintenance treatment in delaying the time-to-relapse in patients with schizophrenia: a randomized, double-blind, placebo-controlled study. Schizophr Res 2010;116:107117.
24.Ware, J Jr, Kosinski, M, Keller, SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996;34:220233.
25.Martin, CR, Allan, R. Factor structure of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4). Psychol Health Med 2007;12:126134.
26.Aki, H, Tomotake, M, Kaneda, Yet al. Subjective and objective quality of life, levels of life skills, and their clinical determinants in outpatients with schizophrenia. Psychiatry Res 2008;158:1925.
27.Faulkner, G, Cohn, T, Remington, G, Irving, H. Body mass index, waist circumference and quality of life in individuals with schizophrenia. Schizophr Res 2007;90:174178.
28.Lasser, RA, Bossie, CA, Gharabawi, GM, Kane, JM. Remission in schizophrenia: Results from a 1-year study of long-acting risperidone injection. Schizophr Res 2005;77:215227.
29.Emsley, R, Medori, R, Koen, L, Oosthuizen, PP, Niehaus, DJ, Rabinowitz, J. Long-acting injectable risperidone in the treatment of subjects with recent-onset psychosis: a preliminary study. J Clin Psychopharmacol 2008;28:210213.
30.Gharabawi, GM, Gearhart, NC, Lasser, RAet al. Maintenance therapy with once-monthly administration of long-acting injectable risperidone in patients with schizophrenia or schizoaffective disorder: a pilot study of an extended dosing interval. Ann Gen Psychiatry 2007;6:3.
31.Davis, JM, Chen, N. Dose response and dose equivalence of antipsychotics. J Clin Psychopharmacol 2004;24:192208.
32.Glick, ID, Marder, SR. Long-term maintenance therapy with quetiapine versus haloperidol decanoate in patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry 2005;66:638641.
33.Webber, MA, Marder, SR. Better pharmacotherapy for schizophrenia: what does the future hold? Curr Psychiatry Rep 2008;10:352358.
34.Perkins, DO, Gu, H, Weiden, PJ, McEvoy, JP, Hamer, RM, Lieberman, JA. Predictors of treatment discontinuation and medication nonadherence in patients recovering from a first episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder: a randomized, double-blind, flexible-dose, multicenter study. J Clin Psychiatry 2008;69:106113.
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Acta Neuropsychiatrica
  • ISSN: 0924-2708
  • EISSN: 1601-5215
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