The Texas Medication Algorithm Project Antipsychotic Algorithm for Schizophrenia

Moore, Troy; Boyer, Robert; Buckley, Peter F.; Chiles, John A.; Conley, Robert R.; Crismon, M. Lynn; Essock, Susan M.; Finnerty, Molly; Marder, Stephen R.; Miller, Del D.; McEvoy, Joseph P.; Robinson, Delbert G.; Schooler, Nina R.; Shon, Steven P.; Stroup, T. Scott; Miller, Alexander L.

doi:10.4088/jcp.v68n1115

Cited by 253 publications

(136 citation statements)

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“…Alternatively, it is also possible that direct effects on the pancreatic b cell predispose vulnerable individuals to an earlier diabetes onset. These findings call into question the use of olanzapine as a first-line treatment for firstepisode schizophrenia (Moore et al, 2007) and underscore that the anticipated benefits of using olanzapine early on in the treatment algorithm should clearly outweigh the increased risk for diabetes; otherwise lower metabolic risk antipsychotics should be used.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotics Associated with the Development of Type 2 Diabetes in Antipsychotic-Naïve Schizophrenia Patients

Nielsen¹,

Skadhede²,

Correll³

2010

Neuropsychopharmacol

188

137

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Section: Discussionmentioning

confidence: 99%

Antipsychotics Associated with the Development of Type 2 Diabetes in Antipsychotic-Naïve Schizophrenia Patients

Nielsen¹,

Skadhede²,

Correll³

2010

Neuropsychopharmacol

188

137

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“…Psychotic patients in first episode, due to increased sensitivity to side effects have typical dosing ranges approximately 50% of the doses used in chronically ill individuals. 11 If there is no improvement after 3 to 4 weeks at therapeutic doses, change of antipsychotic should be considered. 11,12 Improvement is slow and steady and usually takes over 6 to 12 weeks or longer.…”

Section: Introductionmentioning

confidence: 99%

Cost analysis of antipsychotic drugs available in India

Shukla

Agnihotri²

2017

Int J Basic Clin Pharmacol

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Background: Indian drug market has large numbers of branded formulations for every drug molecule. 1 Cost-sensitive healthcare environment has created a challenging workplace for clinicians. Efficient use of healthcare resources without compromising quality of patient care has been a challenging task for healthcare professionals. There is a wide range of variation in the prices of drugs marketed in India. Thus, a study was planned to analyse out cost variations of antiepileptic drugs available in Indian market.Methods: Minimum and maximum costs in Rupees (INR) of different brands of same generic antipsychotic drugs, in the same strength and dosage forms were compared. The cost ratio and percentage cost variation were calculated for each generic antipsychotic drug. The number of formulations for antipsychotic drugs and number of brands for each of them were also taken into consideration.Results: This study shows that in Indian market, there are wide variations in the prices of different brands of same generic antipsychotic drug. The highest cost ratio and percent cost variation was found for risperidone 2 mg [(1:16.27) and 1527.48], followed by risperidone 4 mg [(1:16.25) and 1525.25], risperidone 3 mg [(1:15.67) and 1467.33], risperidone 1 mg [(1:14.86) and 1386.78], olanzapine 10 mg [(1:12.36) and 1136.84], and olanzapine 5 mg [(1:12.31) and 1130.76]. Highest number of brands of antipsychotic drug available in Indian market are for divalproex sodium 500mg(25) followed by olanzapine 15 mg(23), olanzapine 5 mg(23), olanzapine 2.5mg(14), and risperidone 1 mg (14). Highest numbers of formulations of antipsychotic drug available in Indian market are for olanzapine(06), quetiapine(05), haloperidol(05), and aripiprazole(05).Conclusions: In Indian market, the average percentage price variation of different brands of the same oral antipsychotic drugs is very wide. Treatment with antipsychotic drugs usually has a long course with treatment adherence being a crucial factor for successful treatment. Improved adherence to the drug treatment can be ensured by decreasing the cost of therapy. Decreased drug cost expenditure can be ensured by changes in the government policies and regulations, integrating pharmacoeconomics as part of medical education curriculum, and creating awareness among treating physicians for switching to cost effective therapy.

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“…Despite higher costs, SGAs were widely adopted worldwide [9][10][11][12]. However, none of the newer SGAs could demonstrate superiority to clozapine and in the last decade many published clinical practice guidelines [13][14][15][16][17][18][19][20] have recommended that clozapine be prescribed to patients with treatment-resistant schizophrenia, which has been defined as not responsive to two trials of any other antipsychotic medication (either FGA or SGA). Despite such recommendations and the overwhelming evidence of clozapine effectiveness, prescribing of clozapine appears to be low, delayed and often preceded by attempts at polypharmacy treatment, which lacks clinical evidence of effectiveness [21][22][23][24][25][26].…”

Section: Introductionmentioning

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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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 Texas Medication Algorithm Project Antipsychotic Algorithm for Schizophrenia

Cited by 253 publications

References 0 publications

Antipsychotics Associated with the Development of Type 2 Diabetes in Antipsychotic-Naïve Schizophrenia Patients

Antipsychotics Associated with the Development of Type 2 Diabetes in Antipsychotic-Naïve Schizophrenia Patients

Cost analysis of antipsychotic drugs available in India

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

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