“Real world” study of antipsychotic effectiveness for chronic inpatients with schizophrenia in a state psychiatric hospital: Preliminary results and commentary

Abstract

Background: Concerns about the therapeutic and neurological benefits of Second Generation Antipsychotics (SGAs), and financial conflicts of interest and possible biases in the recruitment of research participants, prompted this “real world” study of antipsychotic effectiveness for schizophrenia in the naturalistic setting of a public psychiatric hospital.

Method: Patients who gave informed consent were evaluated with the Brief Psychiatric Rating Scale and the Clinical Global Impression Scale. Neurological side effects were rated with the Simpson-Angus Scale, the Abnormal Involuntary Movement Scale, and the Barnes Akathisia Scale.

Results: During the study there were 38 eligible patients out of a total 123 admissions, but only 10 gave consent. Baseline symptoms were moderate, with minimal neurological side effects. Although 8 out of 10 received SGAs, during an average 234 days of hospitalization, there was no significant change in any measure, and little change in medications.

Conclusions: These preliminary results raise questions about difficulties in patient recruitment, cost-effectiveness of SGAs, polypharmacy and criteria used to determine discharge readiness.

Declaration of interest: This study was not supported by any federal, state, local or private grants.

Keywords:

• Schizophrenia
• second-generation antipsychotics
• antipsychotic effectiveness