An audit of use of high doses of antipsychotics

Abstract

Prescription of high dose antipsychotics remains a common practice, contrary to available evidence. Studies have found that, on average, high daily doses of antipsychotics are no more effective or are less effective than are moderate doses, and have indicated that higher doses are associated with a greater incidence of side effects which may be worse than with a moderate dosage range in the treatment of schizophrenia. The objectives of the study were to examine the safety of high dose antipsychotic use in treating patients with psychotic illnesses in hospital settings in Edmonton and to examine different variables which are associated with treatment resistant schizophrenia in patients who received high-dose antipsychotics and which could be of predictive value for determining poor response to antipsychotics. Results showed that a statistical difference was reached with regard to the non-improvement with high doses versus regular doses, confirming that increasing the doses above recommended ranges does not lead to further amelioration of symptoms. Also, a statistical difference was reached with regard to concurrent medical conditions being more frequent in the high dose group versus regular dose group. The high dose group had a higher number of previous episodes.