Optimized use of Atypical Antipsychotics Associated With Equal Efficacy and Brief Hospital Stays in Patients With Acute Psychosis

Victoria, Australia (ots/PRNewswire) - A new study published by
physicians from the Mental Health Research Institute and Monash
University of Victoria, Australia, showed that all atypical
antipsychotics studied were equally efficacious when used at optimal
doses as primary medication for inpatients with acute psychosis.(1)
They were associated with remarkably brief hospital stays. This
hospital-based study adds to the clinical evidence regarding patient
response patterns to the best treatment approaches of acute psychosis
in real-life clinical practice.

The study published in the International Journal of Psychiatry in
Clinical Practice also found that patients treated with the atypical
antipsychotics quetiapine, risperidone or olanzapine as primary
treatment, in addition to adjunctive medications, showed a similar
time to efficacy (mean time to efficacy was 11.2, 10.2 and 11.2 days,
respectively).(1) The mean doses of atypical antipsychotics used were
567 mg quetiapine, 4.1 mg risperidone or 22.5 mg olanzapine.

Overall, hospital stays for these patients were remarkably brief
despite their initial severe psychopathological disturbances.
Patients treated with quetiapine, risperidone and olanzapine were
discharged from hospital in just over two weeks (means of 17.0, 16.7
and 15.8 days, respectively). All medication schedules were
associated with good tolerability and no serious side effects were
seen. Patients receiving quetiapine required significantly less
benzodiazepines as co-medication compared to patients receiving
risperidone or olanzapine.

Lead investigator Professor Nicholas Keks, Mental Health Hospital
Research Institute of Victoria, Australia, commented: "Acute
psychosis is a severe mental condition that greatly disturbs the life
of affected individuals and their families. The most important aim of
therapy is to alleviate symptoms rapidly and, using medication
optimally, to facilitate return to community care. The atypical
antipsychotics studied clearly help to achieve a return to normal
life for these patients."

This study also examined a more rapid titration schedule of the
atypical antipsychotic quetiapine (n = 32) than the current approved
prescribing information. Most patients responded well to the
accelerated titration, which started at 150-400 mg of quetiapine on
day one and increased to higher doses in the course of treatment.

Prof Keks added: "Clinical guidelines are very important. However,
it is even more important to fine-tune the therapy approach to the
individual to achieve the optimal treatment outcome, especially in
acute psychosis. Some patients seem to respond well to higher doses
of atypicals or faster titration of quetiapine although larger
studies are necessary to support our findings."

Acute mental illness causes a significant strain on the healthcare
and societal resources. Acute psychosis can appear suddenly in
untreated individuals with schizophrenia, or schizophrenia-spectrum
disorders, but also people suffering from bipolar disorder or major
depression. It is estimated that approximately one percent of the
population are affected by schizophrenia,(2) four percent by
schizophrenia-spectrum disorders,(3) three to four percent by bipolar
disorder(4) and six percent by major depression(5).

The retrospective, naturalistic study conducted by Professor
Nicholas Keks and colleagues over a period of 12 months at Box Hill
Hospital acute psychiatric care unit during 2001 included 137
inpatients who were prescribed atypical antipsychotics as first-line
treatment for their acute psychosis. In total, 37 patients received
quetiapine, 38 risperidone and 56 olanzapine in addition to other
medications. Treatment protocols were developed from published
guidelines.

The study was funded by the Mental Health Research Institute
of Victoria.

References:

1) Keks N, Tonso M, Tabone K, et al. Clinical experience with
atypical antipsychotics in an acute inpatient unit: focus on
quetiapine. Int J Psychiatry Clin Practice 2006;10(2):138-41.

2) Suppina AL, Patten SB. Self-reported diagnoses of schizophrenia
and psychotic disorders may be valuable for monitoring and
surveillance. Can J Psychiatry 2006;51(4):256-9.

3) Mattia JI, Zimmerman M. Epidemiology. In Livesley WJ, ed. The
handbook of personality disorders. New York, NY: The Guilford Press,
2001;107-23.

4) Hirschfeld RMA, Calabrese JR, Weissman MM, et al. Screening for
bipolar disorder in the community. J Clin Psychiatry 2003;64:53-9.

5) Wittchen ES, Jacobi F. Size and burden of mental disorders in
Europe - a critical review and appraisal of 27 studies. Eur
Neuropsychopharmacology 2005;15:357-76.

ots Originaltext: Mental Health Research Institute and Monash University of Victoria, Australia
Im Internet recherchierbar: http://www.presseportal.de

Contact:
For further information, please contact Professor Nicholas Keks on
+61-418-559-341, or Mr Ross Johnson in the Media Communications
Office on +61-393-881-633