Multiple Versus Single Antipsychotic Agents for Hospitalized Psychiatric Patients: Case-Control Study of Risks Versus Benefits

Centorrino, Franca; Gören, Jessica L.; Hennen, John; Salvatore, Paola; Kelleher, J. Paul; Baldessarini, Ross J.

doi:10.1176/appi.ajp.161.4.700

Cited by 224 publications

(180 citation statements)

References 21 publications

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“…A relationship between illness severity, longer in-patient stay and receiving high doses of antipsychotics has been observed in the past. 14 This suggests that, all other conditions being equal, patients with severe illness tend to stay in hospital longer and are more likely to require higher doses of antipsychotics. Compared with those who did not receive antipsychotic combinations, the risk of receiving high dosages was 9 times higher if prescribed FGA/SGA or SGA/SGA combinations, increasing to 25 times greater if any combination of antipsychotics were used.…”

Section: Factors Associated With High-dose Antipsychotic Usementioning

confidence: 99%

Polypharmacy and high-dose antipsychotics at the time of discharge from acute psychiatric wards

2011

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Aims and methodTo determine the extent of prescribed antipsychotic polypharmacy and high-dose antipsychotics at the time of discharge from an acute psychiatric ward. Copies of discharge summaries for patients between the ages of 18 and 65 were examined; only those that had antipsychotic medications at the time of discharge were included. Names and doses of antipsychotics and all other medications concurrently prescribed were recorded.ResultsA total of 651 discharge summaries were included in the study. Nearly a quarter of individuals were discharged on one antipsychotic as the only medication to take home; only 6.8% were discharged on a high-dose antipsychotic and of those on combinations 59.6% were on depot medications. Combining antipsychotics significantly predicted the use of high dose.Clinical implicationsMost patients were discharged on doses of antipsychotics within the British National Formulary limits; however, a small proportion is still sent home on high doses of antipsychotics. Combining antipsychotics remains the strongest predictor of high-dose antipsychotic use; clinicians need to be aware of this.

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Section: Factors Associated With High-dose Antipsychotic Usementioning

confidence: 99%

Polypharmacy and high-dose antipsychotics at the time of discharge from acute psychiatric wards

2011

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“…70 Multiple antipsychotics were more beneficial than monotherapy at lower dosages but no better than monotherapy at higher dosages. 70 Four of the six studies reported on side effects-three reported a trend toward greater side effects with multiple antipsychotics 66,68,70 and the fourth reported significantly greater side effects in this group. 68 We identified six noncontrolled observational studies that examined the relationship between antipsychotic polypharmacy and clinical outcomes in samples without documented treatment resistance to monotherapy (Table 2).…”

Section: Samples Without Established Treatment Resistance To Antipsycmentioning

confidence: 92%

“…[65][66][67][68][69][70] Three of the trials studied samples with mixed diagnoses, 65-67 whereas three studied schizophrenia or schizoaffective disorder. [68][69][70] Of the four trials reporting clinical outcomes, three reported no improvement, 65,66,69 while the fourth study reported mixed results. 70 Multiple antipsychotics were more beneficial than monotherapy at lower dosages but no better than monotherapy at higher dosages.…”

Section: Samples Without Established Treatment Resistance To Antipsycmentioning

confidence: 99%

When Is Antipsychotic Polypharmacy Supported by Research Evidence? Implications for QI

Gören

Parks

Ghinassi

et al. 2008

The Joint Commission Journal on Quality and Patient Safety

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“…Studies suggest that there are several side effects associated with such treatments [76,77]. Questions have been raised pertaining to the application of single versus multiple antipsychotic agents as therapeutics [78]. Therefore, search for safer, effective alternative therapy is the need of the time.…”

Section: Reviewmentioning

confidence: 99%

Neurochemicals, Behaviours and Psychiatric Perspectives of Neurological Diseases

Choudhury¹,

Sahu²,

Ramanujam³

et al. 2018

Neuropsychiatry

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Structural changes in different regions of the brain have become clinically relevant and regarded as the signature phenomenon for neurological diseases. Morphological changes in brain are also associated with neuronal and neurochemical alterations. Studies have showed that minute changes in neurochemical levels may have marked impact on the psychobehaviour of the subject. Several neurological disease profiles have been reported with such specific psychobehavioural expression. However, application of behavioural abnormalities as possible disease progress markers has not been considered and emphasised much. Reports suggested that-the subjects, who have already entered into the terminal stage of the disease, used to show cardinal behavioural signs for a specific disease profile. However, psychological expressions are comparatively early expressive. As most of the neurodegenerative disorders are unidirectional and progressive by nature, therapeutic intervention at the right time is essential for attaining the desired outcome. Moreover, early diagnosis can aid in managing the disease progression also. Psychobehavioural analysis could meet the expected outcome of disease diagnosis if implemented properly and timely. In the present review, we have amalgamated the reported behavioural anomalies with the supportive background from neurochemical basis. Further, we have concluded that behaviour centric studies could be a potential diagnostic tool for the early diagnosis of major neurological diseases such as Alzheimer disease, Parkinson's disease, Amyotrophic lateral sclerosis (ALS), Bipolar disorder, Schizophrenia, Impulse control disorder (ICD) and Obsessive-compulsive disorder (OCD).

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Multiple Versus Single Antipsychotic Agents for Hospitalized Psychiatric Patients: Case-Control Study of Risks Versus Benefits

Cited by 224 publications

References 21 publications

Polypharmacy and high-dose antipsychotics at the time of discharge from acute psychiatric wards

Polypharmacy and high-dose antipsychotics at the time of discharge from acute psychiatric wards

When Is Antipsychotic Polypharmacy Supported by Research Evidence? Implications for QI

Neurochemicals, Behaviours and Psychiatric Perspectives of Neurological Diseases

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