P0259 - Antipsychotics in psychiatric inpatients: Naturalistic data on first vs. repeated episodes

Abstract

Antipsychotics are widely used in psychiatric patients for various indications, beside psychosis most often in mood disorders, BPSD in dementia and agitation. Official guidelines are based on RCT data which differ from naturalistic data on the use of antipsychotics in real-life clinical setting.

The aim of our cross-sectional naturalistic study of hospitalized psychiatric patients (n=310) was to get insight into prescription patterns for antipsychotics. We were especially interested in the class of antipsychotic, dose and combinations with other antipsychotics and other psychiatric drugs compared with diagnosis and number of hospitalizations. Structured data sheet was used to record data from medical records.

Results have confirmed the use of antipsychotics in variety of indications outside psychosis, especially mood disorders and agitation. Newer antipsychotics predominate although older antipsychotics have been used consistently in patients with longer illness duration and more hospitalizations (especially depot formulations), in acute agitation control as well as in acute mania and in combinations with atypical antipsychotics. Patients with first few hospitalizations are likely to receive antipsychotic therapy according to guidelines with atypical drugs in monotherapy. Equivalent doses for atypical antipsychotics although are usually higher then for typicals and lower for first hospitalizations.

The real-life use of antipsychotics is an important issue for different reasons including long-term treatment, burden of potential serious long-term side-effects as well as the quality of life in patients. Our data show that real-life uses of antipsychotics differ in some patient populations from recommended for various reasons that will be discussed.