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Employment Outcomes in a Randomized Trial of Second-Generation Antipsychotics and Perphenazine in the Treatment of Individuals with Schizophrenia

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Abstract

Employment has been increasingly recognized as an important goal for individuals with schizophrenia. Previous research has shown mixed results on the relationship of specific antipsychotic medications to employment outcomes, with some studies finding greater benefits for second-generation antipsychotic medications (SGAs) over first-generation antipsychotic medication (FGAs). A randomized controlled trial (CATIE) examined medication assignment and both employment outcomes and participation in psychosocial rehabilitation (PSR) among 1,121 individuals with a diagnosis of schizophrenia randomized to SGAs (olanzapine, quetiapine, risperidone, ziprasidone) or one FGA (perphenazine). Service use and employment were assessed at quarterly interviews. There were no differences between medication groups on employment outcomes or participation in PSR. Consistent with other CATIE results, there were no differences in employment or participation in PSR among these five medications, including the FGA perphenazine.

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Acknowledgement

Dr. Resnick reports no financial disclosures. Dr. Rosenheck reports having received research funding from AstraZeneca Pharmaceuticals LP, Bristol–Myers Squibb, and Eli Lilly and Co.; and consulting fees from Bristol–Myers Squibb, Eli Lilly and Co., and Janssen Pharmaceutica Products. Dr. Lieberman reports having received research funding from AstraZeneca Pharmaceuticals LP, Bristol–Myers Squibb, GlaxoSmithKline, Janssen Pharmaceutica Products, and Pfizer Inc.; and consulting and educational fees from AstraZeneca Pharmaceuticals LP, Bristol–Myers Squibb, Eli Lilly and Co., Forest Pharmaceutical Company, GlaxoSmithKline, Janssen Pharmaceutica Products, Novartis, Pfizer Inc., and Solvay. Dr. Stroup reports having received research funding from Eli Lilly and Co.; and consulting fees from Janssen Pharmaceutica Products, GlaxoSmithKline, and Bristol–Myers Squibb. Dr. McEvoy reports having received research funding from AstraZeneca, Forest Research Institute, Eli Lilly and Co., Janssen Pharmaeutica, and Pfizer Inc.; consulting or advisory board fees from Pfizer Inc. and Bristol–Myers Squibb; and lecture fees from Janssen Pharmaceutica, and Bristol–Myers Squibb. Dr. Swartz reports having received research funding from Eli Lilly and Co., and consulting and educational fees from AstraZeneca Pharmaceuticals LP, Bristol–Myers Squibb, Eli Lilly and Co., and Pfizer Inc. Dr. Perkins reports having received research funding from AstraZeneca Pharmaceuticals LP, Bristol–Myers Squibb, Otsuka Pharmaceutical Co., Ltd, Eli Lilly and Co., Janssen Pharmaceutica Products, and Pfizer Inc.; and consulting and educational fees from AstraZeneca Pharmaceuticals LP, Bristol–Myers Squibb, Eli Lilly and Co., Janssen Pharmaceuticals, and Pfizer Inc. Dr. Keefe reports having received research funding from AstraZeneca, Eli Lilly and Co., and Janssen Pharmaeutica; consulting fees or advisory board payments from Forest Labs, Eli Lilly and Co., Janssen Pharmaceutica, Pfizer Inc., and Bristol–Myers Squibb; and lecture fees from Eli Lilly and Co. and Janssen Pharmaceutica. Drs. Leslie, Sindelar, Miller, Lin, and Hsaio report no financial disclosures. The CATIE Study Investigators Group includes: Lawrence Adler, M.D., Clinical Insights, Glen Burnie, MD; Mohammed Bari, M.D., Synergy Clinical Research, Chula Vista, CA; Irving Belz, M.D., Tri-County/MHMR, Conroe, TX; Raymond Bland, M.D., Southern Illinois University School of Medicine, Springfield, IL; Thomas Blocher, M.D., MHMRA of Harris County, Houston, TX; Brent Bolyard, M.D., Cox North Hospital, Springfield, MO; Alan Buffenstein, M.D., The Queen’s Medical Center, Honolulu, HI; John Burruss, M.D., Baylor College of Medicine, Houston, TX; Matthew Byerly, M.D., University of Texas Southwestern Medical Center at Dallas, Dallas, TX; Jose Canive, M.D., Albuquerque VA Medical Center, Albuquerque, NM; Stanley Caroff, M.D., Veterans Affairs Medical Center and the University of Pennsylvania, Philadelphia, PA; Charles Casat, M.D., Behavioral Health Center, Charlotte, NC; Eugenio Chavez-Rice, M.D., El Paso Community MHMR Center, El Paso, TX; John Csernansky, M.D., Washington University School of Medicine, St. Louis, MO; Pedro Delgado, M.D., University Hospitals of Cleveland, Cleveland, OH; Richard Douyon, M.D., VA Medical Center, Miami, FL; Cyril D’Souza, M.D., Connecticut Mental Health Center, New Haven, CT; Ira Glick, M.D., Stanford University School of Medicine, Stanford, CA; Donald Goff, M.D., Massachusetts General Hospital, Boston, MA; Silvia Gratz, M.D., Eastern Pennsylvania Psychiatric Institute, Philadelphia, PA; George T. Grossberg, M.D., St. Louis University School of Medicine-Wohl Institute, St. Louis, MO; Mahlon Hale, M.D., New Britain General Hospital, New Britain, CT; Mark Hamner, M.D., Medical University of South Carolina and Veterans Affairs Medical Center, Charleston, SC; Richard Jaffe, M.D., Belmont Center for Comprehensive Treatment, Philadelphia, PA; Dilip Jeste, M.D., University of California-San Diego, VA Medical Center, San Diego, CA; Anita Kablinger, M.D., Louisiana State University Health Sciences Center, Shreveport, LA; Ahsan Khan, M.D., Psychiatric Research Institute, Wichita, KS; Steven Lamberti, M.D., University of Rochester Medical Center, Rochester, NY; Michael T. Levy, M.D., PC, Staten Island University Hospital, Staten Island, NY; Jeffrey Lieberman, M.D., University of North Carolina School of Medicine, Chapel Hill, NC; Gerald Maguire, M.D., University of California Irvine, Orange, CA; Theo Manschreck, M.D., Corrigan Mental Health Center, Fall River, MA; Joseph McEvoy, M.D., Duke University Medical Center, Durham, NC; Mark McGee, M.D., Appalachian Psychiatric Healthcare System, Athens, OH; Herbert Meltzer, M.D., Vanderbilt University Medical Center, Nashville, TN; Alexander Miller, M.D., University of Texas Health Science Center at San Antonio, San Antonio, TX; Del D. Miller, M.D., University of Iowa, Iowa City, IA; Henry Nasrallah, M.D., University of Cincinnati Medical Center, Cincinnati, OH; Charles Nemeroff, M.D., Ph.D., Emory University School of Medicine, Atlanta, GA; Stephen Olson, M.D., University of Minnesota Medical School, Minneapolis, MN; Gregory F. Oxenkrug, M.D., St. Elizabeth’s Medical Center, Boston, MA; Jayendra Patel, M.D., University of Mass Health Care, Worcester, MA; Frederick Reimher, M.D., University of Utah Medical Center, Salt Lake City, UT; Silvana Riggio, M.D., Mount Sinai Medical Center-Bronx VA Medical Center, Bronx, NY; Samuel Risch, M.D., University of California–San Francisco, San Francisco, CA; Bruce Saltz, M.D., Henderson Mental Health Center, Boca Raton, FL; Thomas Simpatico, M.D., Northwestern University, Chicago, IL; George Simpson, M.D., University of Southern California Medical Center, Los Angeles, CA; Michael Smith, M.D., Harbor—UCLA Medical Center, Torrance, CA; Roger Sommi, Pharm.D., University of Missouri, Kansas City, MO; Richard M. Steinbook, M.D., University of Miami School of Medicine, Miami, FL; Michael Stevens, M.D., Valley Mental Health, Salt Lake City, UT; Andre Tapp, M.D., VA Puget Sound Health Care System, Tacoma, WA; Rafael Torres, M.D., University of Mississippi, Jackson, MS; Peter Weiden, M.D., SUNY Downstate Medical Center, Brooklyn, NY; James Wolberg, M.D., Mount Sinai Medical Center, New York, NY.

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Correspondence to Sandra G. Resnick PhD.

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Resnick, S.G., Rosenheck, R.A., Canive, J.M. et al. Employment Outcomes in a Randomized Trial of Second-Generation Antipsychotics and Perphenazine in the Treatment of Individuals with Schizophrenia. J Behav Health Serv Res 35, 215–225 (2008). https://doi.org/10.1007/s11414-007-9101-3

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