Naturalistic Pharmacotherapy of Acute Episodes of Schizophrenic Disorders in Comparison to Treatment Guidelines

作者：Stein M; Dietrich D E; Agelink M W; Becker W; Chrysanthou C; Driessen M; Kruse G; Machleidt W; Reker T; Schneider U; Moenking H Schulze; Emrich H M; Arolt V; Rothermundt M^*

来源：Pharmacopsychiatry, 2012, 45(5): 189-195.

DOI：10.1055/s-0031-1301286

• schizophrenia
• medication
• pharmacotherapy
• guideline
• naturalistic treatment

Introduction: This study was designed to investigate to what extent guidelines regarding the pharmacological treatment of patients suffering from schizophrenia-like psychosis are adopted in a naturalistic treatment setting. %26lt;br%26gt;Methods: Medical records of n=819 patients undergoing inpatient treatment for schizophrenia-like psychosis in 11 psychiatric hospitals in northwestern Germany were retrospectively analyzed and findings were compared to current schizophrenia guideline recommendations. %26lt;br%26gt;Results: The prescription rate of second generation antipsychotics increased from 47.1% on admission to 62.5% at discharge. Only half the patients (52.3%) received antipsychotic monotherapy while 47.7% took between 2 and 4 antipsychotic substances at a time. Dosage increases occurred most frequently (in 60%) within the first week of inpatient treatment, 16.6% experienced an elevation between days 15 and 29. A change within the atypical medication was found in 19,3%. Clozapine prescriptions increased throughout the treatment but were combined with other antipsychotic substances in the majority of cases. %26lt;br%26gt;Conclusion: Under naturalistic conditions guideline recommendations for treatment of schizophrenia-like psychosis are adhered to only partially. Combination therapy with 2 or more antipsychotic drugs is quite common despite a clear recommendation for monotherapy.

• 出版日期2012-7