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Pharmacopsychiatry 2012; 45(05): 189-195
DOI: 10.1055/s-0031-1301286
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

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

M. Stein
1   Department of Psychiatry, University Hospital Münster, Münster, Germany
,
D. E. Dietrich
2   Department for Clinical Psychiatry and Psychotherapy, Medizinische Hochschule Hannover, Hannover, Germany
,
M. W. Agelink
3   Department of Psychiatry, Psychotherapy and Psychosomatics, Herford, Germany
,
W. Becker
4   Psychiatric Hospital Wahrendorff, Sehnde, Germany
,
C. Chrysanthou
5   LWL Hospital Lengerich, Lengerich, Germany
,
M. Driessen
6   Department of Psychiatry and Psychotherapy, Bethel, Germany
,
G. Kruse
7   Department of Psychiatry and Psychotherapy, Langenhagen, Germany
,
W. Machleidt
8   Department for Social Psychiatry and Psychotherapy, Medizinische Hochschule Hannover, Hannover, Germany
,
T. Reker
9   LWL Hospital Münster, Münster, Germany
,
U. Schneider
10   Department of Psychiatry, Psychotherapy and Psychosomatics, Lübbecke, Germany
,
H. Schulze Mönking
11   St. Rochus-Hospital, Telgte, Germany
,
H. M. Emrich
2   Department for Clinical Psychiatry and Psychotherapy, Medizinische Hochschule Hannover, Hannover, Germany
,
V. Arolt
1   Department of Psychiatry, University Hospital Münster, Münster, Germany
,
M. Rothermundt
1   Department of Psychiatry, University Hospital Münster, Münster, Germany
12   Department of Psychiatry, Psychotherapy and Psychosomatics, Evangelisches und Johanniter Klinikum Niederrhein, Oberhausen, Germany
› Author Affiliations
Further Information

Publication History

received 17 August 2009
revised 15 December 2011

accepted 22 December 2011

Publication Date:
28 March 2012 (online)

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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
 

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