title: Predictors of the discharge dosage of an atypical antipsychotic agent among hospitalized, treatment-naive, first-episode psychosis patients in naturalistic, public-sector settings.
abstract: OBJECTIVE
  Little is known about determinants of second-generation antipsychotic dosages during initial hospitalization of first-episode psychosis. This study examined potential predictors of dosage of an atypical antipsychotic agent, risperidone, at hospital discharge after initial evaluation and treatment of first-episode nonaffective psychosis in 3 naturalistic, public-sector treatment settings.
  
  
  METHODS
  The number of psychotropic agents prescribed and discharge antipsychotic dosage were abstracted from the medical record. Demographic and extensive clinical characteristics were assessed through a clinical research study conducted at the 3 sites. One-way analyses of variance, trend tests using specific linear combinations of estimates, and χ² tests assessed for associations between atypical antipsychotic dosage and 5 hypothesized predictors, as well as 12 exploratory variables.
  
  
  RESULTS
  Among 155 hospitalized first-episode patients, 121 (78.1%) were discharged on risperidone, and subsequent analyses focused on that subset. The mean risperidone dosage among those 121 patients was 4.26 mg; 31 received 1 to 2 mg, 45 received 3 to 4 mg, 37 received 5 to 6 mg, and 8 received more than 6 mg. Analyses suggested that older age at hospitalization, the number of psychotropic agents prescribed, excited symptoms, and premorbid social functioning may be predictors of the discharge dosage.
  
  
  CONCLUSIONS
  Although several factors emerged, in general, predictors of discharge dosages of second-generation agents, here exemplified by risperidone, in real-world practice settings remain to be clarified. Given the importance of antipsychotic initiation during first hospitalization, future research should test an even broader array of potential predictors.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, NW, Washington, DC 20037, USA. mcompto@emory.edu
authors.forename: Michael T
authors.initials: MT
authors.lastname: Compton
authors.forename: Mary E
authors.initials: ME
authors.lastname: Kelley
authors.forename: Robert Brett
authors.initials: RB
authors.lastname: Lloyd
authors.forename: Tamela
authors.initials: T
authors.lastname: McClam
authors.forename: Claire E
authors.initials: CE
authors.lastname: Ramsay
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Haggard
authors.forename: Sara
authors.initials: S
authors.lastname: Augustin
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D017150:Public Sector; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents