title: Trends in the pharmacological treatment of patients with schizophrenia over a 12 year observation period.
abstract: In this study we evaluated whether our efforts to promote evidence-based guidelines for the psychopharmacological treatment of patients with schizophrenia have led to measurable changes of treatment practice in our hospital by investigating three primary hypotheses: 1) Polypharmacy has become less common in recent years, 2) Conventional neuroleptics have been replaced by second generation antipsychotics; and 3) Dosing regimes have changed towards lower doses. We have therefore collected data from the clinical records of all in-patients with ICD-9/ICD-10 diagnoses of schizophrenia hospitalized at the Department of Psychiatry of the Medical University Innsbruck in the years 1989, 1995, 1998 and 2001. Data from 1989 to 1998 showed a significant decrease in the use of two or more antipsychotics given simultaneously. Contrary to our hypothesis, there was a significant increase in polypharmacy between 1998 and 2001. The predominant use of second generation antipsychotics became standard in schizophrenia treatment. In this context the decrease of concomitant anticholinergic medication is notable. Doses of conventional antipsychotics like haloperidol as well as doses of risperidone decreased whereas doses of other second generation antipsychotics increased. All in all, the pharmacological management of schizophrenia patients is increasingly in tune with current treatment guidelines.
authors: Department of Biological Psychiatry, Medical University Innsbruck Anichstrasse 35 A-6020, Austria. monika.edlinger@uklibk.ac.at
authors: Monika
authors: M
authors: Edlinger
authors: Armand
authors: A
authors: Hausmann
authors: Georg
authors: G
authors: Kemmler
authors: Martin
authors: M
authors: Kurz
authors: Ilsemarie
authors: I
authors: Kurzthaler
authors: Thomas
authors: T
authors: Walch
authors: Michaela
authors: M
authors: Walpoth
authors: W Wolfgang
authors: WW
authors: Fleischhacker
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000639:trends; D005069:Evaluation Studies as Topic; D019317:Evidence-Based Medicine / Q000639:trends*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019370:Observation; D012189:Retrospective Studies; D012559:Schizophrenia / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D014150:Antipsychotic Agents