Predictors of the discharge dosage of an atypical antipsychotic agent among hospitalized, treatment-naive, first-episode psychosis patients in naturalistic, public-sector settings

Michael T. Compton, Mary E. Kelley, Robert Brett Lloyd, Tamela McClam, Claire E. Ramsay, Patrick J. Haggard, Sara Augustin

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: Little is known about determinants of second-generation antipsychotic dosages during initial hospitalization of first-episode psychosis. This study examined potential predictors of dosage of an atypical antipsychotic agent, risperidone, at hospital discharge after initial evaluation and treatment of first-episode nonaffective psychosis in 3 naturalistic, public-sector treatment settings. Methods: The number of psychotropic agents prescribed and discharge antipsychotic dosage were abstracted from the medical record. Demographic and extensive clinical characteristics were assessed through a clinical research study conducted at the 3 sites. One-way analyses of variance, trend tests using specific linear combinations of estimates, and χ tests assessed for associations between atypical antipsychotic dosage and 5 hypothesized predictors, as well as 12 exploratory variables. Results: Among 155 hospitalized first-episode patients, 121 (78.1%) were discharged on risperidone, and subsequent analyses focused on that subset. The mean risperidone dosage among those 121 patients was 4.26 mg; 31 received 1 to 2 mg, 45 received 3 to 4 mg, 37 received 5 to 6 mg, and 8 received more than 6 mg. Analyses suggested that older age at hospitalization, the number of psychotropic agents prescribed, excited symptoms, and premorbid social functioning may be predictors of the discharge dosage. Conclusions: Although several factors emerged, in general, predictors of discharge dosages of second-generation agents, here exemplified by risperidone, in real-world practice settings remain to be clarified. Given the importance of antipsychotic initiation during first hospitalization, future research should test an even broader array of potential predictors.

Original languageEnglish (US)
Pages (from-to)10-15
Number of pages6
JournalJournal of Clinical Psychopharmacology
Volume31
Issue number1
DOIs
StatePublished - Feb 1 2011

Keywords

  • atypical antipsychotics
  • first-episode psychosis
  • positive symptoms
  • risperidone
  • schizophrenia
  • second-generation antipsychotics

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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