Why do physicians switch antipsychotic treatment from other neuroleptics to olanzapine? The „Physician drug stereotype“

There is a lack of research on why physicians select a certain drug in an individual case and not another alternative, although this drug selection process is important for the understanding of treatment, for quality assurance and cost control. 495 psychiatrists documented treatment of 1711 schizophrenic outpatients who were switched from an ongoing neuroleptic treatment to olanzapine, and of another 1654 whose present neuroleptic medication was continued and filled in the „Reason for Treatment Selection Questionnaire“ (RTSQ). Patients who were switched to olanzapine were more ill, showed more EPS and were less compliant. Reasons to switch were the expectation of better efficacy and fewer side effects. Reasons not to switch were good efficacy and tolerability of the present treatment and patient preferences to continue with the present medication. The „physician drug stereotype“ of olanzapine corresponds with clinical data on the efficacy and tolerability of olanzapine. Results show that medical decisions are multidimensional. The RTSQ which can assess important aspects of medical decision making and generate a psychological drug profile.