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Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
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Antipsychotic use in a first episode psychosis program
Rahul Manchanda1, Ross M G Norman, Ashok K Malla
1Prevention and Early Intervention Program for Psychoses (PEPP), London Health Sciences Centre, London, Ontario, Canada.
International Journal of Psychiatry in Clinical Practice
|June 18, 2014
Summary
In first episode psychosis, most patients stayed on antipsychotics, but half switched medications within 6 months. This study observed prescribing patterns of atypical neuroleptics in real-world clinical practice.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- First episode psychosis requires effective and sustained treatment.
- Atypical neuroleptics are commonly prescribed for psychosis.
- Understanding real-world prescribing patterns is crucial for optimizing patient care.
Purpose of the Study:
- To investigate prescribing patterns of atypical neuroleptics in drug-naïve first episode non-affective psychosis patients.
- To compare risperidone and olanzapine in a naturalistic setting.
- To analyze medication changes and adherence over two years.
Main Methods:
- Longitudinal, naturalistic study of 193 first episode psychosis patients.
- Patients received risperidone or olanzapine as per clinical protocol.
- Data collected on socio-demographics, clinical characteristics, and medication management over 2 years.
Main Results:
- Initiation of antipsychotic medication was slower for outpatients versus inpatients.
- No significant differences observed between risperidone and olanzapine in time to maximum dose, dropout rates, or concomitant medication use.
- While most patients remained on an antipsychotic, 50% changed their initial medication by 6 months.
Conclusions:
- Clinical practice for first episode psychosis differs from rigid trial protocols.
- Medication changes are common within the first two years of treatment.
- Polypharmacy was infrequent in this patient cohort.
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