“Many patients with first-episode psychosis receive medications that do not comply with recommended guidelines for first-episode treatment,” states a National Institute of Mental Health press release about a new NIMH study published in the American Journal of Psychiatry. The study found that about 40% of patients who’d been diagnosed with having psychotic experiences for the first time in their lives were being too heavily medicated right away.
The study is part of the Recovery After an Initial Schizophrenia Episode (RAISE) project, “which was developed by NIMH to examine first-episode psychosis before and after specialized treatment was offered in community settings in the United States,” states the press release. “RAISE seeks to change the path and prognosis of schizophrenia through coordinated and intensive treatment in the earliest stages of illness… Current guidelines emphasize low doses of antipsychotic drugs and strategies for minimizing the side effects that might contribute to patients stopping their medication.”
The researchers found that, out of 159 people,
- 8.8 percent were prescribed higher-than-recommended doses of antipsychotics;
- 23.3 percent were prescribed more than one antipsychotic;
- 36.5 percent were prescribed an antipsychotic and an antidepressant without a clear need for the antidepressant;
- 10.1 percent were prescribed psychotropic medications without an antipsychotic medication,
- and 1.2 percent were prescribed stimulants.
- In addition, 32.1 percent were prescribed olanzapine, a medication not recommended for first-episode patients.
- Some of the 159 people fell into multiple categories.
“Despite some regional variations in prescription practices, no region consistently had different practices from the others,” wrote the authors of the study. “Diagnosis had limited and inconsistent effects.”
Medications for patients with first episode psychosis may not meet guidelines (National Institutes of Health Press Release, December 4, 2014)
(Abstract) Prescription Practices in the Treatment of First-Episode Schizophrenia Spectrum Disorders: Data From the National RAISE-ETP Study (Robinson, Delbert G. et al. American Journal of Psychiatry. Published online ahead of print December 4, 2014.)