PMID- 15056517
OWN - NLM
STAT- MEDLINE
DCOM- 20040624
LR  - 20151119
IS  - 0002-953X (Print)
IS  - 0002-953X (Linking)
VI  - 161
IP  - 4
DP  - 2004 Apr
TI  - Multiple versus single antipsychotic agents for hospitalized psychiatric 
      patients: case-control study of risks versus benefits.
PG  - 700-6
AB  - OBJECTIVE: Since use of multiple drugs to treat psychiatric patients is 
      increasing, and research on this practice is rare, the authors carried out a 
      retrospective case-control study of multiple versus single antipsychotic 
      treatment in psychiatric inpatients. METHOD: Inpatient treatment groups receiving 
      either antipsychotic monotherapy or polytherapy were matched in terms of age, 
      sex, diagnostic category, and admission clinical ratings (Global Assessment of 
      Functioning [GAF] and Clinical Global Impression [CGI]), which yielded 70 subject 
      pairs. They were compared in terms of total chlorpromazine-equivalent daily dose, 
      changes in total daily dose, length of hospitalization, incidence of adverse 
      effects, and changes in clinical ratings (CGI, GAF, Positive and Negative 
      Syndrome Scale score) between admission and discharge. RESULTS: Initial doses 
      were closely similar at admission for both treatment groups, but the median total 
      final antipsychotic dose was 78% higher for those receiving antipsychotic 
      polytherapy versus monotherapy. Also, median length of stay in the hospital was 
      55% (8.5 days) longer, and risk of adverse effects was 56% higher with 
      polytherapy, whereas clinical improvement scores were similar (within 11%) for 
      both treatments. CONCLUSIONS: Short-term treatment with multiple antipsychotics 
      was associated with major increases in drug exposure, adverse events, and time in 
      the hospital but with no apparent gain in clinical benefit. These findings 
      require further testing in controlled prospective studies.
FAU - Centorrino, Franca
AU  - Centorrino F
AD  - Department of Psychiatry and Neuroscience Program, Harvard Medical School and 
      Bipolar and Psychotic Disorders Clinic, McLean Hospital, Boston, MA USA. 
      centorf@mcleanpo.mclean.org
FAU - Goren, Jessica L
AU  - Goren JL
FAU - Hennen, John
AU  - Hennen J
FAU - Salvatore, Paola
AU  - Salvatore P
FAU - Kelleher, James P
AU  - Kelleher JP
FAU - Baldessarini, Ross J
AU  - Baldessarini RJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Psychiatry
JT  - The American journal of psychiatry
JID - 0370512
RN  - 0 (Antipsychotic Agents)
RN  - U42B7VYA4P (Chlorpromazine)
SB  - IM
CIN - Am J Psychiatry. 2005 Mar;162(3):631-2; author reply 632-3. PMID: 15741496
CIN - Am J Psychiatry. 2005 Mar;162(3):631; author reply 632-3. PMID: 15741497
CIN - Am J Psychiatry. 2005 Mar;162(3):632; author reply 632-3. PMID: 15741498
MH  - Adult
MH  - Antipsychotic Agents/administration & dosage/*therapeutic use
MH  - Case-Control Studies
MH  - Chlorpromazine/administration & dosage/*therapeutic use
MH  - Combined Modality Therapy
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hospitalization
MH  - Hospitals, Psychiatric
MH  - Humans
MH  - Male
MH  - Psychotic Disorders/*rehabilitation
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Schizophrenia/*rehabilitation
MH  - Surveys and Questionnaires
EDAT- 2004/04/02 05:00
MHDA- 2004/06/25 05:00
CRDT- 2004/04/02 05:00
PHST- 2004/04/02 05:00 [pubmed]
PHST- 2004/06/25 05:00 [medline]
PHST- 2004/04/02 05:00 [entrez]
AID - 10.1176/appi.ajp.161.4.700 [doi]
PST - ppublish
SO  - Am J Psychiatry. 2004 Apr;161(4):700-6. doi: 10.1176/appi.ajp.161.4.700.