Real-World Pharmacotherapy with Novel Antipsychotics

Abstract

Recent psychopharmacological advances have greatly increased medication management options for psychotic disorders. However, exporting new, better-tolerated, and possibly more effective treatments from the clinical trial setting to real-world clinical practice poses a number of challenges. The authors describe recent research efforts to demonstrate the effectiveness of the newer antipsychotic treatments under real-world conditions, including cost-effectiveness analyses and medical effectiveness studies that suggest that the newer medications may be able to produce improved clinical outcomes with considerable cost savings. They then describe recent efforts in Illinois to track continuity of medication management and adherence problems in patients with severe mental illness between discharge from state hospitals and outpatient follow-up in the community. These studies suggest that discontinuities in the overall management of care may substantially undercut the potential therapeutic benefits, improved outcomes, and costs savings associated with the newer antipsychotic agents. The authors conclude that better efforts to provide continuity of care and linkage between inpatient and outpatient community services are needed to maximize the benefits of the newer antipsychotics.