Inpatient antipsychotic drug use in 1998, 1993, and 1989.
OBJECTIVE
Patterns of clinical use of antipsychotic agents have changed greatly in the past decade. The authors' goal was to examine these patterns.


METHODS
They evaluated medication use in all McLean Hospital inpatients treated with antipsychotic drugs during 3 months in 1998 (N=349) and compared the results with McLean Hospital inpatients treated with antipsychotics in 1993 (N=299) and Boston area inpatients in 1989 (N=50).


RESULTS
The most commonly prescribed antipsychotics in 1998 were atypical agents; olanzapine was prescribed more often than risperidone or quetiapine, which were prescribed more often than other antipsychotics. Two or more antipsychotics were prescribed at some time during their hospitalization for 150 (43%) of the patients in 1998. The total discharge dose in chlorpromazine equivalents for the 349 patients for whom antipsychotics were prescribed at discharge was 371 mg/day, 29% higher than the total discharge dose for patients in 1993 and 46% greater than the dose in 1989. The dose of antipsychotics was greater for patients with psychotic illnesses than for those with affective illnesses. Higher doses were associated with greater clinical improvement, polypharmacotherapy, and younger patient age.


CONCLUSIONS
Emerging trends toward higher total antipsychotic doses and polypharmacotherapy require critical assessments of cost-benefit relationships.
Centorrino
Franca
F
Department of Psychiatry and Neuroscience Program, Harvard Medical School, Boston, MA 02478-9106, USA. centorf@mcleanpo.mclean.org
Eakin
Marion
M
Bahk
Won-Myong
WM
Kelleher
James P
JP
Goren
Jessica
J
Salvatore
Paola
P
Egli
Samy
S
Baldessarini
Ross J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged
D014150:Antipsychotic Agents