Use of combinations of antipsychotics: McLean Hospital inpatients, 2002
| Autor: | Gabriele Sani, John Hennen, Alessandra Talamo, Francesca Guzzetta, Kate V. Fogarty, Mark G. Saadeh, Ross J. Baldessarini, Paola Salvatore, Franca Centorrino, Stephanie L. Cincotta |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Hospitals Psychiatric Male medicine.medical_specialty Databases Factual medicine.medical_treatment antipsychotics bipolar disorder combination polypharmacy polytherapy schizophrenia Pharmacotherapy Internal medicine medicine Humans Pharmacology (medical) Bipolar disorder Antipsychotic Psychiatry Psychiatric Status Rating Scales Affective psychosis Polypharmacy Inpatients Relative efficacy business.industry Data interpretation Length of Stay medicine.disease Patient Discharge Drug Combinations Psychiatry and Mental health Treatment Outcome Psychotic Disorders Neurology Schizophrenia Data Interpretation Statistical Drug Therapy Combination Female Neurology (clinical) Pharmacy Service Hospital business Antipsychotic Agents |
| Zdroj: | Human Psychopharmacology: Clinical and Experimental. 20:485-492 |
| ISSN: | 1099-1077 0885-6222 |
| DOI: | 10.1002/hup.719 |
| Popis: | Background The empirical use of combinations of antipsychotic agents appears to be increasing with little research support for the relative efficacy, safety or cost-effectiveness of this practice. Such treatment was evaluated in hospitalized psychiatric patients. Methods Samples of consecutive inpatients treated with ≥ 2 (‘polytherapy’) vs 1 antipsychotic (‘monotherapy’) were matched on age, sex, diagnosis and admission clinical ratings, and these groups were compared on total daily chlorpromazine-equivalent doses, days in hospital, and changes in clinical ratings between admission and discharge. Results The study sample included 69 polytherapy and 115 well-matched monotherapy subjects. Despite matching for initial CGI and GAF ratings, polytherapy was associated with high PANSS subscale scores of positive symptoms among affective psychosis, and relatively greater PANSS subscale ratings of excitement-agitation among patients diagnosed with schizophrenia. Estimated clinical improvement during hospitalization was similar among poly- and monotherapy patients, but total daily CPZ-eq doses at discharge averaged twice-greater with polytherapy, and hospitalization lasted 1.5 times longer. Conclusions Antipsychotic polytherapy as well as the types of agents combined may reflect clinician responses to particular symptom patterns. The value of specific combinations of antipsychotic agents and their comparison with monotherapies requires specific, prospective, randomized and well-controlled trials that consider matching on clinical characteristics and truly comparable doses across regimens. Copyright © 2005 John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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