Conventional, Atypical, and Combination Antipsychotic Prescriptions: A 2-Year Comparison
J Clin Psychiatry 2003;64(6):673-679
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The purpose of this study was
to determine if there is a relationship between the type of
antipsychotic prescribed (conventional, atypical, or a
combination) and patients' use of psychiatric services and
prescription of adjuvant medications.
Method: A chart review of 83 outpatients
with long-term psychiatric disorders recorded the type and dosage
of psychiatric medications prescribed in 1997-1998 (T1) and 2
years later, in 1999-2000 (T2). Psychiatric service use was also
noted during the 2-year follow-up.
Results: Atypical prescriptions increased
from 27% (N = 22) to 45% (N = 37) 2 years later. At T2,
35% of patients (N = 29) were prescribed conventionals, and 19%
(N = 16) were prescribed a combination of conventionals and
atypicals. The mean antipsychotic dosage in chlorpromazine
equivalents (546.5 mg/day) increased significantly (p < .05).
There was no difference between the 3 groups in their use of
psychiatric services or the prescription of adjuvant medications,
with the exception of less common prescription of
anticholinergics. There was also no difference in psychiatric
service use between patients who remained on treatment with
combined antipsychotics at T1 and T2 (11%; N = 9) and the rest of
the sample. Patients who were switched from one type of
antipsychotic to another made more use of psychiatric services,
Conclusion: Contrary to our expectations,
patients prescribed combined antipsychotic types did not make
more use of psychiatric services or use more adjuvant
medications. The high percentage of patients prescribed a
combination may be due to antipsychotic polypharmacy preferences
and may represent a very slow crossover from one antipsychotic to