title: Substantial increase in number and dosage of antipsychotics in non-responsive vs. responsive schizophrenia inpatients.
abstract: INTRODUCTION Current clinical guidelines recommend the use of a single antipsychotic drug for acute schizophrenic exacerbation. We examined whether this approach is also employed in non-responsive schizophrenia inpatients. METHODS Forty-one consecutively admitted schizophrenic inpatients were assigned into a study group [n=22; non-responsive (ΔBPRS&lt;10%) to two consecutive trials of antipsychotics prior to and following 24 weeks of hospitalization] and a comparison group [n=19; partial-to-good (ΔBPRS=10-27%) responders under similar settings]. RESULTS The number and dosage of antipsychotics were increased by 34% and 40% (P=0.016 and P=0.062, respectively) in the study group compared to the comparison subjects following 24 weeks of hospitalization. In the study group, a significant correlation was found between the number of antipsychotics administered and their dose (r=0.22, n=88, P=0.04). CONCLUSION Clinicians do not comply with evidence-based algorithms, and treat non-responsive schizophrenia inpatients with a combination of antipsychotics and at substantially higher doses compared to partial-to-good responders. Our findings discourage such practice.
authors.affiliation: Geha Psychiatric Hospital, Beilinson Campus, Petah Tikva Felsenstein Medical Research Center, Tel Aviv University Tel Aviv.
authors.forename: Roni
authors.initials: R
authors.lastname: Shiloh
authors.forename: Igor
authors.initials: I
authors.lastname: Gutnik
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Hanan
authors.initials: H
authors.lastname: Munitz
keywords: Antipsychotic Drugs; Responders; Schizophrenia