polypharmacy
Conditions
Interventions
All patients in the experimental group will be involved in an intention to treat strategy to rationalize and if possible reduce their polypharmacy during one year. To this purpose an algorithm has bee
the clozapine treated group is further
distinguished into formerly clozapine-monotherapy-tested patients, and not-clozapine-monotherapy-tested patients. While the latter group is switched to clozapine
the latter group is switched to monotherapy with an antipsychotic of their own choice in an adequate dosage regarding D2 blockade. If effective and without intolerable side effects, this antipsychotic
Sponsors
A.Wunderink, Friesland Mental Health Services and University Center of Psychiatry, University Medical Center Groningen
Eligibility
Inclusion criteria
Inclusion criteria: Patients between 18-65 years of age with a schizophrenia diagnosis (according to the SCID-P), currently taking at least two antipsychotic drugs, and willing to consider a change in antipsychotic medication.
Exclusion criteria
Exclusion criteria: Having symptoms or side effects so severe that a medication change is indicated immediately; having an exacerbation of psychiatric symptoms within the past 3 months resulting in significant intervention such as having spent one or more nights in psychiatric hospitalization or having received services from a crisis intervention program or psychiatric emergency department; living in a skilled nursing facility as a result of a physical condition or disability; having pending criminal charges; currently pregnant or breastfeeding; for patients with prescriptions of quetiapine the dosage has to be more than 100 mg/day in order to exclude those for whom this agent was prescribed primarily as a sleep aid.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Personal and social performance as measured by the Personal and Social Performance scale (Morosini et al, 2000) | — |
Secondary
| Measure | Time frame |
|---|---|
| Proportion and duration of realized algorithm based monotherapy, symptom severity, relapse rates, side effects, health related costs, consumer-involvement | — |
Contacts
Public ContactA. Wunderink
University Medical Center Groningen (UMCG), Department of Psychiatry, P.O. Box 30001
Outcome results
None listed