Patients With Schizophrenia at Risk for Excessive Antipsychotic Dosing

Depot antipsychotic use in schizophrenia: an East Asian perspective

“…Depot antipsychotic use was associated with higher daily antipsychotic doses, a finding consistent with those of other reports (Walkup et al, 2000;Valenstein et al, 2001). Walkup et al (2000) found that the use of depot antipsychotics increased the odds of higher daily antipsychotic doses by a factor of 30, a figure considerably higher than that in this study.…”

“…Walkup et al (2000) found that the use of depot antipsychotics increased the odds of higher daily antipsychotic doses by a factor of 30, a figure considerably higher than that in this study. This is of concern especially when depot antipsychotics are given over a long period of time (Tavcar et al, 2000).…”

Prescribing of Antipsychotic Medication in a Medicaid Population: Use of Polytherapy and Off-Label Dosages

“…Recent reports describing antipsychotic medication use in current practice settings reveal a high prevalence of combination therapy with multiple antipsychotic medication regimens [15][16][17] and the use of high-dose therapies. [18][19][20] Although randomized placebo-controlled trials are lacking, therapies that combine antipsychotic medications may hold promise for certain patient subtypes, [21][22][23][24] and growing evidence suggests a benefit of high-dose therapy for some patients with treatment-resistant disease. 25,26 However, studies describing the dose-response relationship pertaining to the efficacy and toxicity of the atypical antipsychotics are lacking.…”

Clinicians’ Reasons for Deviations from Recommended Dosing Practices for Antipsychotic Medications

“…However, while many guidelines and recommendations for the pharmacologic treatment of schizophrenia have been developed in recent years (Lehman and Steinwachs 1998a;Lehman et al 2004;APA 1997;Chiles et al 1999;McEvoy et al 1996), studies that have evaluated adherence to them in actual practice have shown substantial rates of non-adherence (Chen et al 2000), including frequent use of dosages both higher (Walkup et al 2000; Leslie and Rosenheck (2001) and lower (Owen et al 2002) than the recommended ranges, delays in implementing the guidelines (Valenstein et al 2001), or failure to change antipsychotic medications when guidelines would suggest that such changes are indicated (Sernyak et al 2003).…”