Comparing the use and discontinuation of antipsychotics in clinical practice: an observational study.
BACKGROUND
There are few independent studies comparing atypical or second-generation antipsychotics (SGAs).


OBJECTIVE
To compare the patterns of use and discontinuation of commonly used SGAs.


METHODS
Retrospective review of 11,250 case records (2002-2005) of all mental health care contacts in a discrete geographical setting in Scotland. Patterns of use, mean dose, psychotropic co-prescription, duration of treatment, discontinuation rates, and admission rates were examined for amisulpride, clozapine, olanzapine, quetiapine, and risperidone.


RESULTS
Clozapine had a significantly lower discontinuation rate in individuals with schizophrenia, compared to the other 4 SGAs. Off-license prescribing and polypharmacy were common.


CONCLUSIONS
SGAs are variously used for schizophrenia and mood disorder and have heterogeneous outcomes, with clozapine being most effective in this study. Independent observational studies such as this complement randomized controlled trials.
Taylor
Mark
M
Springpark Centre, Glasgow, United Kingdom. mark.taylor@glacomen.scot.nhs.uk
Shajahan
Polash
P
Lawrie
Stephen M
SM
D000328:Adult; D000368:Aged; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D003024:Clozapine / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D000077152:Olanzapine; D010343:Patient Admission; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D000069348:Quetiapine Fumarate; D012107:Research Design; D012189:Retrospective Studies; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D012606:Scotland; D013469:Sulpiride / Q000031:analogs & derivatives / Q000627:therapeutic use
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D013469:Sulpiride; D000077582:Amisulpride; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine