Substantial increase in number and dosage of antipsychotics in non-responsive vs. responsive schizophrenia inpatients

Author： Shiloh Roni Gutnik Igor Weizman Abraham Munitz Hanan

ISSN： 1365-1501

Source： International Journal of Psychiatry in Clinical Practice, Vol.7, Iss.1, 2003-01, pp. : 53-57

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Abstract

INTRODUCTION Current clinical guidelines recommend the use of a single antipsychotic drug for acute schizophrenic exacerbation. We examined whether this approach is also employed in non-responsive schizophrenia inpatients.METHODS Forty-one consecutively admitted schizophrenic inpatients were assigned into a study group [n=22; non-responsive (ΔBPRS<10%) to two consecutive trials of antipsychotics prior to and following 24 weeks of hospitalization] and a comparison group [n=19; partial-to-good (ΔBPRS=10-27%) responders under similar settings].RESULTS The number and dosage of antipsychotics were increased by 34% and 40% (P=0.016 and P=0.062, respectively) in the study group compared to the comparison subjects following 24 weeks of hospitalization. In the study group, a significant correlation was found between the number of antipsychotics administered and their dose (r=0.22, n=88, P=0.04).CONCLUSION Clinicians do not comply with evidence-based algorithms, and treat non-responsive schizophrenia inpatients with a combination of antipsychotics and at substantially higher doses compared to partial-to-good responders. Our findings discourage such practice.