Managing Suicide Risk in Patients with Schizophrenia

Kasckow, John; Felmet, Kandi; Zisook, Sidney

doi:10.2165/11586450-000000000-00000

Cited by 115 publications

(102 citation statements)

References 126 publications

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“…The evidence supports a clear advantage of clozapine therapy in terms of reduced mortality over other antipsychotic agents including FGAs, risperidone and quetiapine [39][40][41][42].…”

Section: Clozapine Effectiveness On Mortalitymentioning

confidence: 68%

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

Lee¹,

Shin²,

Kim³

et al. 2017

J Int Korean Med

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Background: Clozapine effectiveness in the treatment of refractory schizophrenia has been sustained by published evidence in the last two decades, despite the introduction of safer options. Discussion: Current clinical practice guidelines have strongly recommended the use of clozapine in treatment-resistant schizophrenia, but prescribing trends do not appear to have followed such recommendations. Clozapine is still underutilized especially in patients at risk of suicide. It seems that physicians are hesitant in prescribing clozapine due to concerns about serious adverse effects. Recent reports have highlighted the need to inform health professionals about the benefits of treating patients with clozapine and have voiced concerns about the underutilization of clozapine especially in patients at risk of suicide. Summary: Guidelines and prescribing patterns reported in various countries worldwide are discussed. Suggestions on how to optimize clozapine utilization have been published but more efforts are needed to properly inform and support prescribers' practices.

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“…The evidence supports a clear advantage of clozapine therapy in terms of reduced mortality over other antipsychotic agents including FGAs, risperidone and quetiapine [39][40][41][42].…”

Section: Clozapine Effectiveness On Mortalitymentioning

confidence: 68%

“…It has also been suggested that earlier use (as a second line agent) can be recommended in individuals with persistent hostility/aggressive behaviour [47] and suicidalilty [39][40][41][42]. In fact the indication for recurrent suicidal behavior has been officially approved by the FDA [48].…”

Section: Discussionmentioning

confidence: 99%

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

Lee¹,

Shin²,

Kim³

et al. 2017

J Int Korean Med

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“…Apart from depression, the other psychiatric condition which shares this symptom and contributes significantly to the number of suicides committed is schizophrenia [112]. However, pharmacotherapy of suicidal ideation/behaviour is still premature.…”

Section: Pharmacological Management Of Suicidal Ideationmentioning

confidence: 99%

Ketamine and suicidal ideation in depression: Jumping the gun?

Rajkumar

Fam

Yeo

et al. 2015

Pharmacological Research

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“…It implies different prescription habits linked to differences in psychiatric training provisions in the two countries. More generally, data on the utility of antipsychotics in reducing risk for suicide in patients with schizophrenia are, although appreciably favorable, still limited, except for clozapine, the only antipsychotic treatment approved by the Food and Drug Administration for this indication (Kasckow et al, 2011;Meltzer et al, 2003).…”

Section: Factors Favoring the Prescription Of Depot Formsmentioning

confidence: 99%

1151 – Clinicians’ attitudes toward the use of long-acting injectable antipsychotics

Samalin

Charpeaud

Heres³

et al. 2013

European Psychiatry

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Depot formulations are not widely used in everyday practice. This study aimed to assess psychiatrists' attitudes toward the use of long-acting injectable (LAI) antipsychotics in schizophrenia. We interviewed 113 French psychiatrists about the factors that influenced their prescription of LAI antipsychotics. Multidimensional and cluster analyses were used to detect correlations. The most important factor against the use of LAI antipsychotics is a sufficient estimated compliance with the oral formulation. For first-generation LAI, the main factor is the risk for extrapyramidal symptoms; and for secondgeneration LAI, it is the unavailability of the equivalent oral formulation. Four factors incite the psychiatrists to prescribe LAI. Two different clusters of patients can also be identified. Most factors influencing the clinicians' attitudes toward the use of LAI antipsychotics are shared in many countries. Conversely, some attitudes related to organizational aspects, particularly the relevance of health care costs, may vary from one country to another.Key Words: Antipsychotics, long-acting injectable, attitudes, schizophrenia (J Nerv Ment Dis 2013;201: 553Y559) A ccording to systematic reviews, between 40% and 60% of patients with schizophrenia are known to be partially or totally noncompliant to oral antipsychotic medication (Dolder et al., 2002;Valenstein et al., 2004). Poor adherence is associated with higher risk for relapse of schizophrenia and increased health care costs (Patel et al., 2008).However, depot formulations are not widely used in routine practice, with a prescription rate of generally lower than 30% in different countries (Barnes et al., 2009; Patel and David, 2011). However, the use of long-acting injectable (LAI) formulations varies between countries. The prescription rates are higher in France (23.5%;Fourrier et al., 2000) and in the United Kingdom (29%; Barnes et al., 2009) compared with other European countries and with Canada (6.3%; Williams et al., 2006) or the United States (17.6%; West et al., 2008).This discrepancy between countries can be considered to derive from the health care system and from the different attitudes displayed by psychiatrists.Perceived coercion or presumed risks for lower tolerance of depot forms have been identified as factors responsible for this low use (Heres et al., 2006; Patel and David, 2011). More generally, negative attitudes from practitioners toward these forms have been shown to account for part of the low prescription rates of depot antipsychotics (Hamann et al., 2010;Heres et al., 2006Heres et al., , 2008Heres et al., , 2011.The main goal of our study was to assess the attitudes of psychiatrists toward LAI antipsychotics in patients with schizophrenia to understand the reasons for using or not assigning depot treatment.We studied these attitudes in a sample of psychiatrists working in France using the same questionnaire that was used in a population of German psychiatrists (Heres et al., 2006(Heres et al., , 2008. Our results will be discus...

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Managing Suicide Risk in Patients with Schizophrenia

Cited by 115 publications

References 126 publications

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

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

Ketamine and suicidal ideation in depression: Jumping the gun?

1151 – Clinicians’ attitudes toward the use of long-acting injectable antipsychotics

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