The clinical impact of reported variance in potency of antipsychotic agents.
There is significant disagreement on the clinical equivalence (or potency) of antipsychotic agents, with up to 500% variance reported in texts. To address the extent and consequences of these discrepancies, we took a random sample of 18 common psychiatry, psychopharmacology and pharmacology texts for antipsychotic equivalence tables. We found a marked variation in stated equivalences for the majority of antipsychotics. Most affected were the high potency (haloperidol, fluphenazine) and newer (molindone) drugs, which had a 500% variance. This variation inadvertently contributes to the misuse of these agents. For instance, high-potency antipsychotics are prescribed in far larger doses than necessary, leading to decreased efficacy and increased side effects. Steps to simplify and rationalize the use of these agents are recommended.
Dewan
M J
MJ
Department of Psychiatry, State University of New York, Syracuse 13210, USA.
Koss
M
M
D014150:Antipsychotic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D011618:Psychotic Disorders / Q000188:drug therapy*; D013782:Textbooks as Topic; D013810:Therapeutic Equivalency
D014150:Antipsychotic Agents