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Antipsychotic monotherapy and adjuvant psychotropic therapies in schizophrenia patients: effect on time to readmission

Valevski, Avia; Gilat, Yarona; Olfson, Markc; Benaroya-Milshtein, Noaa; Weizman, Abrahama,b

International Clinical Psychopharmacology:
doi: 10.1097/YIC.0b013e328350ddbe
Original Articles
Abstract

This study assessed the relationship between pharmacological regimens at hospital discharge and hospital readmission among schizophrenia patients. The records reviewed were all consecutive admissions (N=720) from a specific catchment area during the period 1991–2005. Two main groups were selected for analysis: the first group (N=537) included patients discharged with first-generation antipsychotics (FGA), and the second group (N=183) included patients with second-generation antipsychotics (SGA). Data on clinical and demographic characteristics at discharge, including a brief psychiatric rating scale and pharmacological treatment, were collected. The rate of readmission within 12 months was analyzed in relation to the specific pharmacological treatment at discharge. There was no significant difference in the risk of readmission in patients treated with SGA compared with FGA. Adjuvant psychotropic medications to either FGA or SGA did not attenuate the risk of readmission. The readmission rate in patients treated with clozapine (N=74) was significantly lower in comparison with depot FGA (N=293) medications (P=0.016). There was no advantage of SGA over FGA, with or without adjuvant psychotropic treatment, with regard to rehospitalization risk during the 12-month follow-up. Clozapine was found to reduce the risk for readmission in comparison with depot FGA.

Author Information

aThe Geha Mental Health Center

bFelsenstein Medical Research Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

cNew York State Psychiatric Institute of Columbia University Medical Center, New York, New York, USA

Correspondence to Avi Valevski, MD, Geha Mental Health Center, 1 Helsinki St., P.O. Box 103, Petach Tikva, Israel Tel: +972 3 925 8283; fax: +972 3 925 8287; e-mail: valevski@gmail.com

Received November 17, 2011

Accepted December 29, 2011

© 2012 Lippincott Williams & Wilkins, Inc.