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

M. Stein; D. E. Dietrich; M. W. Agelink; W. Becker; C. Chrysanthou; M. Driessen; G. Kruse; W. Machleidt; T. Reker; U. Schneider; H. Schulze Mönking; H. M. Emrich; V. Arolt; M. Rothermundt

doi:10.1055/s-0031-1301286

Pharmacopsychiatry, Table of Contents

Pharmacopsychiatry 2012; 45(05): 189-195
DOI: 10.1055/s-0031-1301286

Original Paper

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

M. Stein

¹Department of Psychiatry, University Hospital Münster, Münster, Germany

,

D. E. Dietrich

²Department for Clinical Psychiatry and Psychotherapy, Medizinische Hochschule Hannover, Hannover, Germany

,

M. W. Agelink

³Department of Psychiatry, Psychotherapy and Psychosomatics, Herford, Germany

,

W. Becker

⁴Psychiatric Hospital Wahrendorff, Sehnde, Germany

,

C. Chrysanthou

⁵LWL Hospital Lengerich, Lengerich, Germany

,

M. Driessen

⁶Department of Psychiatry and Psychotherapy, Bethel, Germany

,

G. Kruse

⁷Department of Psychiatry and Psychotherapy, Langenhagen, Germany

,

W. Machleidt

⁸Department for Social Psychiatry and Psychotherapy, Medizinische Hochschule Hannover, Hannover, Germany

,

T. Reker

⁹LWL Hospital Münster, Münster, Germany

,

U. Schneider

¹⁰Department of Psychiatry, Psychotherapy and Psychosomatics, Lübbecke, Germany

,

H. Schulze Mönking

¹¹St. Rochus-Hospital, Telgte, Germany

,

H. M. Emrich

²Department for Clinical Psychiatry and Psychotherapy, Medizinische Hochschule Hannover, Hannover, Germany

,

V. Arolt

¹Department of Psychiatry, University Hospital Münster, Münster, Germany

,

M. Rothermundt

¹Department of Psychiatry, University Hospital Münster, Münster, Germany

¹²Department of Psychiatry, Psychotherapy and Psychosomatics, Evangelisches und Johanniter Klinikum Niederrhein, Oberhausen, Germany

› Author Affiliations

Abstract

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.

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.

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.

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.

Key words

schizophrenia - medication - pharmacotherapy - guideline - naturalistic treatment

Full Text

References

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