The pharmacoepidemiology of treatment-refractory schizophrenia.
Treatment-refractory schizophrenia is a major clinical problem for which there is relatively little scientific information, and no consensus has been reached on approaches to treatment. The pharmacotherapy used for 103 patients with a diagnosis of schizophrenia or schizoaffective disorder at one psychiatric hospital was examined. Data were gathered on neuroleptic choice and dose, the use of adjunctive treatments and serum neuroleptic levels. The daily neuroleptic dose was compared with that of random samples of patients receiving outpatient maintenance treatment, and short-stay patients receiving acute treatment. The patients in our sample received high doses of neuroleptics despite a persistent lack of response to treatment, and despite the fact that these were in excess of the recommended maximum beneficial dose. The appropriateness of this therapy is discussed.
Schizophrenia Research Program, Queen Street Mental Health Centre, Toronto, Ontario.
E J
EJ
Collins
T P
TP
Hogan
A G
AG
Awad
D000203:Activities of Daily Living / Q000523:psychology; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002746:Chlorpromazine / Q000627:therapeutic use; D002908:Chronic Disease; D003024:Clozapine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D009864:Ontario / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents; D011619:Psychotropic Drugs; D003024:Clozapine; D002746:Chlorpromazine