Impact of removing oral neuroleptic liquids from the formulary of a large psychiatric hospital.
Oral liquid formulations of neuroleptic medications have been claimed to offer advantages in treatment of psychotic patients, particularly as a means of ensuring compliance. After a review of the literature, this 900-bed psychiatric facility found no substantial support to indicate that liquids are superior to solid dosage forms. Because of their higher cost, liquid neuroleptics were removed from this formulary. Few changes in prescribing practices were measured after removal of liquids; dosages remained constant and injectable neuroleptic and sedative use actually decreased. Replacing liquid neuroleptic dosage forms with solid dosage forms resulted in an estimated annual savings of nearly $60,000 at this institution. The authors conclude that liquid neuroleptics appear to offer no benefits over solid dosage forms in adult psychiatric patients and can be removed from drug formularies without disruptive effects on psychotropic prescribing practices or clinical care. However, further research is needed to determine the benefits of liquid neuroleptics in special clinical or psychiatric settings.
D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000600:supply & distribution*; D002140:California; D004333:Drug Administration Routes; D005069:Evaluation Studies as Topic; D005572:Formularies, Hospital as Topic / Q000191:economics*; D006746:Hospital Bed Capacity, 500 and over; D006778:Hospitals, Psychiatric / Q000191:economics; D006801:Humans; D008510:Medication Systems, Hospital / Q000191:economics*; D011618:Psychotic Disorders / Q000188:drug therapy*