[Antipsychotics in clinical practice. The refractory schizophrenic patients treatment].
OBJECTIVE
The aim of this paper is to present and to discuss the results of an investigation conducted among Polish psychiatrists in 2007, especially its part relating to the practice of therapeutic patterns in refractory schizophrenia.


METHODS
Structured individual interviews were conducted from 100 psychiatrists chosen at random in 9 larger cities in Poland. The interviews were followed by a questionnaire consisting of 52 questions relating to the principles of treatment and a perception of the features of antipsychotics. One part of the interview focused on refractory schizophrenia treatment. The perception of antipsychotics was interpreted with the use of the Pin Points Analysis method.


RESULTS
In-patient schizophrenic patients are treated most often with clozapine (57%), but olanzapine (38%) and risperidone (32%) are the most common in out-patients. Other neuroleptics are prescribed considerably seldom. According to the doctors' declaration, their choices of medicines would be different, if there were no external limitations in drug prescription. In spite of this, the psychiatrists' claim, that their choice of antipsychotics is based on their own knowledge (44%), to a smaller degree it is based on the experts' recommendations (32%) and the currently valid reimbursement rules (24%).


CONCLUSIONS
The Refractory schizophrenia treatment that is applied in practice, is generally convergent with the principles of the treatment. Clozapine still has a significant place in therapy. Use of all the remaining atypicals, besides risperidone and the olanzapine, they are limited by the high price for patient.
Klinika Rehabilitacji IPiN w Warszawie.
Joanna
J
Meder
Magdalena
M
Tyszkowska
Marek
M
Jarema
Aleksander
A
Araszkiewicz
Tomasz
T
Szafrański
D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000191:economics; D001291:Attitude of Health Personnel; D001569:Benzodiazepines / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005473:Fluoxetine / Q000008:administration & dosage; D006801:Humans; D000077152:Olanzapine; D011044:Poland / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012008:Recurrence; D018967:Risperidone / Q000008:administration & dosage; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012702:Serotonin Antagonists / Q000008:administration & dosage* / Q000191:economics
D014150:Antipsychotic Agents; D012702:Serotonin Antagonists; D005473:Fluoxetine; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine