Relationship of the use of adjunctive pharmacological agents to symptoms and level of function in schizophrenia.
OBJECTIVE
Adjunctive pharmacological agents are extensively used in the treatment of patients with schizophrenia. This cross-sectional study examined the prevalence of the use of adjunctive agents, the extent to which their use conforms with Schizophrenia Patient Outcomes Research Team (PORT) recommendations for adjunctive pharmacological treatment and the relationship of conformance with treatment recommendations to demographic and clinical variables and to symptoms and level of function.


METHODS
Outpatients with schizophrenia (N=344) underwent an extensive interview, and their medical records were reviewed. Data on demographic and clinical characteristics, medications, and role functioning were collected.


RESULTS
More than two-thirds of the outpatients received antiparkinsonian agents, and 50% received an adjunctive agent other than an antiparkinsonian agent. Fifty-four (15.7%) outpatients received two or more non-anti-parkinsonian adjunctive agents. Rates of conformance with the PORT treatment recommendations for the use of adjunctive agents ranged from 49% to 65%, depending on the type of agent. Ethnicity and diagnosis were the only two patient characteristics that were consistently related to conformance with PORT treatment recommendations. The treatment recommendation for adjunctive mood stabilizers was the only recommendation for which conformance was related to multiple measures of patients' symptoms and level of function.


CONCLUSIONS
Adjunctive agents are widely used in the pharmacological treatment of patients with schizophrenia, but there is a limited relationship between use of these agents in conformance with treatment recommendations and measures of symptoms and level of function. Longitudinal, prospective studies are needed to demonstrate the clinical utility of adjunctive agents.
Buchanan
Robert W
RW
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, Baltimore, 21228, USA. rwbuchanan@mprc.umaryland.edu
Kreyenbuhl
Julie
J
Zito
Julie M
JM
Lehman
Anthony
A
D000328:Adult; D000553:Ambulatory Care; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011618:Psychotic Disorders / Q000188:drug therapy; D012559:Schizophrenia / Q000188:drug therapy*; D012720:Severity of Illness Index
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D000928:Antidepressive Agents; D000978:Antiparkinson Agents; D014150:Antipsychotic Agents