Psychiatry

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Antipsychotic Agents: Problems in Prescribing, Adherence, Persistence

KEY POINT

Simultaneous use of multiple antipsychotic agents among inpatients—a trend on the upswing for 4 decades but unsupported by sound clinical evidence—results in longer hospitalizations and possibly more adverse effects but does not improve clinical outcomes, according to a recently published case–control retrospective analysis of data from the spring of 1998. Another study, which analyzed Medicaid data from San Diego County from 1998 to 2000, shows that less than one-half of patients are adherent and persistent with antipsychotic therapy, with large numbers taking too few doses and about one-fifth of patients having their prescriptions refilled too frequently.

SOURCES

Centorrino F et al. Multiple versus single antipsychotic agents for hospitalized psychiatric patients: case-control study of risks versus benefits. Am J Psychiatry. 2004;161:700–6.

Gilmer TP et al. Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry. 2004;161:692–9.

Tamminga CA. Demonstrating drug action [editorial]. Am J Psychiatry. 2004;161:943–5.