Clinicians' reasons for deviations from recommended dosing practices for antipsychotic medications.
OBJECTIVE
This study was designed to investigate clinician rationales for prescribing higher than recommended dosages of antipsychotic medications in patients with schizophrenia.


METHODS
Prescribers for all patients at two VA medical centers whose dosage exceeded PORT recommendations were interviewed.


RESULTS
For 91/107 (85%) of patients, the prescriber responded that the current dosage should not be decreased. Positive symptoms were the most common target symptoms (94%), followed by negative symptoms (26%), anxiety (23%), and insomnia (13%).


CONCLUSIONS
In patients receiving higher than recommended dosages of antipsychotics, clinicians were frequently able to cite specific target symptoms.
Sernyak
Michael Joseph
MJ
Psychiatry Service, 116A, VA Connecticut Healthcare System, West Haven Campus, 950 Campbell Avenue, West Haven, CT 06516, USA. michael.sernyak@yale.edu
Rosenheck
Robert
R
D014150:Antipsychotic Agents / Q000008:administration & dosage*; D019983:Guideline Adherence; D019538:Health Care Surveys; D006787:Hospitals, Veterans; D006801:Humans; D009511:New England; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012559:Schizophrenia / Q000188:drug therapy
D014150:Antipsychotic Agents