Antipsychotic Prescribing Pathways, Polypharmacy, and Clozapine Use in Treatment of Schizophrenia

Child, Parent, and Service Predictors of Psychotropic Polypharmacy Among Adolescents and Young Adults with an Autism Spectrum Disorder

“…One quarter of adolescents and young adults with ASD were taking two or more psychotropic medications, and 13% of individuals taking two or more psychotropic medications were also taking psychotropic medications from the same therapeutic class (e.g., two antipsychotic, mood stabilizer or anxiolytic medications), which, according to prescribing guidelines for individuals with developmental disabilities, should be avoided (Posey et al 2008;Reiss and Aman 1995;Sullivan et al 2011). Psychotropic polypharmacy rates in this study, are similar to those observed in other clinical populations, including youth with symptoms of mania (Kowatch et al 2013) and adults with schizophrenia or schizoaffective disorders (Goren et al 2013). When all factors were considered, the main contributors to psychotropic polypharmacy in the current study were history of hurting others, psychiatric comorbidity, parent burden and therapy service use.…”

A Case of Drug-Induced Acute Dyskinesia Treated with Korean Medicine

“…During phase 3 of the CATIE study, 51% of patients had previously discontinued medications due to ineffective therapeutic response, but only 11% of patients were offered clozapine during phase 3. Studies of clozapine utilization have shown that adherence to guidelines has been poor through the years with clozapine been consistently underutilized in the US, UK, Canada, New Zealand and Australia [9,[21][22][23][24][25][26][42][43][44][45][46]. In a study of the Veterans Health Administration, only 2% of patients affected by schizophrenia were receiving clozapine [22].…”

Personalizing Antipsychotic Treatment of Schizophrenia: Monitoring Plasma Levels for Improved Treatment Decisions

“…21,22 Others may switch drugs prematurely-that is, without instituting such adherence interventions as long-acting injectable antipsychotics or dose changes that will optimize the treatment or make it more tolerable. 23,24 Or if a switch is warranted because of true treatment failure, prescribers rarely switch to clozapine, a highly effective but vastly underused second-or third-line drug.…”

“…23,24 Or if a switch is warranted because of true treatment failure, prescribers rarely switch to clozapine, a highly effective but vastly underused second-or third-line drug. 17,21 Although new antipsychotic drugs have expanded the armamentarium for the treatment of schizophrenia, there have been no breakthroughs that ensure treatment response and tolerability for all patients, or at least predictability of response and tolerability.…”