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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

Authors

  • 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
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