title: Antipsychotic dosage at hospital discharge and outcomes among persons with schizophrenia.
abstract: OBJECTIVE
  Applying the schizophrenia treatment guidelines established by the Patient Outcomes Research Team (PORT) project, this study evaluated whether antipsychotic medication dosage influenced patient outcomes in routine clinical settings.
  
  
  METHODS
  The associations between discharge antipsychotic medication dosage and short-term clinical, social, and service use outcomes were observed in a sample of 246 patients with schizophrenia or schizoaffective disorder.
  
  
  RESULTS
  Patients who were given high dosages of antipsychotic medication at hospital discharge (more than 1,000 chlorpromazine milligram equivalents) had greater severity of symptoms three months after discharge than patients who were given guideline-recommended dosages (300 to 1,000 chlorpromazine milligram equivalents) (adjusted mean Brief Psychiatric Rating Scale scores of 45 and 39, respectively). Patients who were given low dosages of antipsychotic medication at hospital discharge (less than 300 chlorpromazine milligram equivalents) were less likely to report side effects (adjusted OR=.24) and slightly more likely to be nonadherent (21 percent of those within the recommended dose range compared with 39 percent of the those with low doses, not statistically significant after Bonferroni correction). No other differences related to medication dosage were observed in patient outcomes.
  
  
  CONCLUSIONS
  Treatment that falls within antipsychotic medication dosage guidelines is associated with improvement in a limited, but critical, range of short-term patient outcomes in routine clinical settings.
authors.affiliation: Departmenmt of Epidemiology and Population Health, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA. nsohler@montefiore.edu
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Sohler
authors.forename: Jamie
authors.initials: J
authors.lastname: Walkup
authors.forename: Donna
authors.initials: D
authors.lastname: McAlpine
authors.forename: Carol
authors.initials: C
authors.lastname: Boyer
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006302:Health Services Research; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D010349:Patient Compliance; D010351:Patient Discharge; D017410:Practice Guidelines as Topic; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents