title: Use of second-generation antipsychotics in the acute inpatient management of schizophrenia in the Middle East.
abstract: BACKGROUND
  Management of acute psychotic episodes in schizophrenic patients remains a significant challenge for clinicians. Despite treatment guidelines recommending that second-generation antipsychotics (SGAs) should be used as monotherapy, first-generation antipsychotics, polypharmacy, and lower than recommended doses are frequently administered in clinical practice. Minimal data exist regarding the use of SGAs in the Middle East. The objective of this study was to examine the discrepancies between current clinical practice and guideline recommendations in the region.
  
  
  METHODS
  RECONNECT-S Beta was a multicenter, noninterventional study conducted in Egypt, Kuwait, Saudi Arabia, and the United Arab Emirates to observe the management of schizophrenic patients who were hospitalized due to an acute psychotic episode. Patients underwent one visit on the day of discharge. Demographic and medical history, together with data on antipsychotic treatment and concomitant medication during the hospitalization period and medication recommendations at discharge were recorded.
  
  
  RESULTS
  Of the 1,057 patients, 180 (17.0%) and 692 (65.5%) received SGAs as monotherapy and in combination therapy, respectively. Overall, the most frequently administered medications were given orally, and included risperidone (40.3%), olanzapine (32.5%), and quetiapine (24.6%); the doses administered varied between countries and deviated from the recommended guidelines. Upon discharge, 93.9% of patients were prescribed SGAs as maintenance therapy, and 84.8% were prescribed the same medication(s) as during hospitalization.
  
  
  CONCLUSIONS
  Current clinical practice in the Middle East differs from guideline recommendations. Patients frequently received antipsychotics in combination therapy, by various methods of administration, and at doses above and below the recommended guidelines for the management of their acute psychotic episodes.
authors.affiliation: Kuwait Center for Mental Health, Safat, Kuwait, Saudi Arabia.
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Alkhadhari
authors.affiliation: Al Amal Complex for Mental Health Hospital, Dammam, Saudi Arabia.
authors.forename: Nasser
authors.initials: N
authors.lastname: Al Zain
authors.affiliation: Behavioural Science Pavilion, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
authors.forename: Tarek
authors.initials: T
authors.lastname: Darwish
authors.affiliation: Jeddah Psychiatric Hospital, Jeddah, Saudi Arabia.
authors.forename: Suhail
authors.initials: S
authors.lastname: Khan
authors.affiliation: Institute of Psychiatry, Ain Shams University, Cairo, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Okasha
authors.affiliation: Institute of Psychiatry, Ain Shams University, Cairo, Egypt.
authors.forename: Hisham
authors.initials: H
authors.lastname: Ramy
authors.affiliation: Ibrahim Bin Hamad Obaidallah and Seif Bin Ghubash Hospitals, Ras Alkhaimah, United Arab Emirates.
authors.forename: Talaat Matar
authors.initials: TM
authors.lastname: Tadros
keywords: Middle East; acute psychotic episode; schizophrenia; second-generation antipsychotic; treatment guidelines