Antipsychotic medication and length of stay at a psychiatric maximum-security unit in Norway (1987–2000)

Abstract

The aim of this study was to evaluate psychopharmacological treatment and the length of stay (LOS) of patients with schizophrenia in a maximum-security psychiatric unit. Data were collected from the hospital files of 82 consecutively admitted patients with schizophrenia who were both admitted and discharged between the years 1987 and 2000. Psychotropic medication and LOS at the time of discharge were registered. Ninety-five per cent of the patients received antipsychotic medication. Zuclopenthixol was the most frequent medication, given to 43% of the patients. Antipsychotic polypharmacy was found in 20% of the cases. Twenty-seven per cent of the patients were medicated with doses above the recommended therapeutic dose range. During the study period, there was no change in the administration and number of psychotropics, but there was an increase in the dosage of antipsychotics. However, LOS was unchanged during the same time. This supports other findings, which suggest that there is no clinical benefit of higher antipsychotic dosage. It is suggested that an optimized medication practice could yield beneficiary effects, not only for schizophrenic symptoms, but also for violence in schizophrenic patients.

Prescribing Patterns and the Use of Therapeutic Drug Monitoring of Psychotropic Medication in a Psychiatric High-Security Unit

“…The practice of giving high doses of zuclopenthixol has been consistent for many years in the unit, 28 and the doses are also considerably higher than what is reported from a similar patient group in Australia. 29 In fact, in 40% of the cases in the present study, the intramuscular depot dose of zuclopenthixol was higher than recommended in the SPCs, resulting in significantly higher serum concentrations than in the control group.…”

Long-acting injectable antipsychotics for prevention and management of violent behaviour in psychotic patients

“…A glimpse into a real‐life practice, how the high‐risk patients are managed, is for example provided by retrospective data from Norway . The authors reviewed pharmacotherapy of 82 schizophrenia patients (mean age 30 years, only 1 female patient) discharged from maximum security psychiatric facility in Trondheim between 1987 and 2000.…”

“…A glimpse into a real-life practice, how the high-risk patients are managed, is for example provided by retrospective data from Norway. 21 The authors reviewed pharmacotherapy of 82 schizophrenia patients Another cross-sectional review examined prescribing patterns among 189 seriously violent, mentally disordered offenders in a UK high-security hospital. 23 The patients were grouped according to their diagnoses: schizophrenia spectrum disorders (47.1%), personality disorders (18%), and comorbid schizophrenia and personality disorder (29.1%).…”

A systematic review of psychotropic drug prescribing for prisoners

“…The most common theme identified was polypharmacy (Acosta-Armas et al, 2004;Bains and Nielssen, 2003;Bressington et al, 2008;Dalvi et al, 2003;Gray et al, 2008;Harrington et al, 2002;Haw and Stubbs, 2003a;Jukic et al, 2008;Lelliott et al, 2002;Martin et al, 2008;Parker et al, 2002;Paton et al, 2002;Renkel and Rasmussen, 2006;Sazhin and Reznik, 2008;Tavernor et al, 2000;Walker and MacAulay, 2005). Many national and international guidelines state that the use of more than one antipsychotic medication is strongly discouraged in almost all situations (Psychotropic Expert Group, 2008).…”