Treatment of schizophrenia with antipsychotics in Norwegian emergency wards, a cross-sectional national study

Abstract

Background: Surveys on prescription patterns for antipsychotics in the Scandinavian public health system are scarce despite the prevalent use of these drugs. The clinical differences between antipsychotic drugs are mainly in the areas of safety and tolerability, and international guidelines for the treatment of schizophrenia offer rational strategies to minimize the burden of side effects related to antipsychotic treatment. The implementation of treatment guidelines in clinical practice have proven difficult to achieve, as reflected by major variations in the prescription patterns of antipsychotics between different comparable regions and countries. The objective of this study was to evaluate the practice of treatment of schizophrenic patients with antipsychotics at discharge from acute inpatient settings at a national level.

Substance abuse in patients admitted voluntarily and involuntarily to acute psychiatric wards: a national cross-sectional study

“…This comprised 75% of Norwegian hospitals providing acute inpatient treatment. The clinics were located in both urban and rural parts of the country and were assumed to cover a representative sample of the Norwegian population [20]. Data from 3,506 admissions to adult acute psychiatric wards were collected.…”

“…Data on patient characteristics and treatment episodes were collected from all patients admitted during a three-month period. The network was organized and coordinated by the research institute SINTEF Health Research in Norway with support from the Norwegian Directorate of Health and Social Affairs [20,21].…”

Current inpatient prescription practices for the treatment of schizophrenia in public hospitals of Minas Gerais, Brazil

“…3,13,14 The only exceptions were chlorpromazine and levomepromazine, which were used largely (87.8% and 92.6% of the time, respectively) used at doses o 300 mg/day, a practice not supported by pharmacotherapeutic guidelines, 5,6 but common in other countries as well. 10 Combining antipsychotics was a common practice (46.5% of all admissions), although much of this was due to the combined use of low-dose chlorpromazine and levomepromazine as sedative agents (34.0% of all admissions). Thus, the actual intention to combine two effective antipsychotic agents was present in only 12.5% of admissions.…”

“…6 Worldwide reports estimate the rate of combination antipsychotic therapy at 12-48%. 10,15 The most frequently prescribed adjuvant drugs were benzodiazepines (diazepam, clonazepam, lorazepam, nitrazepam, and midazolam), followed by anticholinergics (biperiden and promethazine), anticonvulsants (carbamazepine and valproate), and antidepressants (fluoxetine and tricyclics) ( Table 1). Current treatment guidelines provide for the use of these advujants.…”

“…8 Although clozapine has proven useful in reducing readmission risks in schizophrenia, 9 it was used in only 4.2% of admissions in our sample, a prevalence lower than that reported internationally (8-25%). 10,11 The only available long-acting antipsychotic was haloperidol decanoate. It was used in 6.7% of cases, mostly (71.6%) in its oral formulation.…”