Use of Atypical Antipsychotics in a Community Mental Health Center: Evaluation of Dosing, Drug Combinations, and Gender

Abstract

Objectives: To describe the dosing of atypical antipsychotics among outpatients diagnosed with schizophrenia at a community mental health center in Tucson, AZ, and to contrast this to dosing recommendations set by the manufacturer during clinical trials. Methods: A prescription database from January 01, 2004 to July 31, 2004 was used to evaluate the dosing of atypical antipsychotics (Abilify®, Clozaril®, Geodon®, Seroquel®, and Zyprexa®) in patients with schizophrenia. The average daily doses were evaluated for differences from recommended dosing using the physician desk reference. Differences in dosing were also analyzed for gender and monotherapy vs. patients taking multiple atypical antipsychotics. Results: Overall differences in dosing when comparing gender and monotherapy vs. patients on multiple atypicals were not significant for all five atypical antipsychotics studied. Overall, Geodon® had the highest percentage (51.9%) of patients above recommended guidelines while Clozaril® and Seroquel® had the highest percentage (70.6% and 47.4% respectively) below recommended guidelines. Implications: This study illustrates that dosing of these atypical antipsychotics at this outpatient community mental health center differs for many patients with schizophrenia from the guidelines set by the companies during clinical trials. This information will aid in the prescribing of physicians at this community mental health center and will possibly lead to larger studies to further look at reasons for these differences in dosing.