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1.
Nervenarzt ; 91(1): 34-42, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31919550

RESUMEN

BACKGROUND: Schizophrenia is a severe psychiatric disorder with variable therapeutic responses, the etiology and pathophysiology of which require further elucidation. OBJECTIVE: To review which pharmacological options are effective and safe and for which treatment goals in schizophrenia. MATERIAL AND METHODS: Narrative review of the pharmacological therapy of adults diagnosed with schizophrenia. RESULTS: Despite heterogeneous therapeutic responses, to date only dopamine antagonists or partial agonists are approved for the treatment of schizophrenia. The efficacy of antipsychotic agents differs only gradually, with the exception of clozapine for treatment-resistant schizophrenia, whereas undesired adverse effects are more variable. Those antipsychotic agents that show gradual efficacy advantages in meta-analyses of acute and maintenance treatment (clozapine, amisulpride, olanzapine, risperidone) are also those where at least one undesired adverse effect is most severely expressed. Antipsychotic adverse effects occur in subgroups of patients and are generally tolerable or treatable, whereas the "side effect" of untreated schizophrenia affects almost all patients, including relapses, psychosocial deterioration, secondary treatment resistance and increased mortality. Therefore, in patients with a confirmed diagnosis of schizophrenia, a lifelong continuous therapy is currently most likely indicated, ideally with antipsychotic agents for which adherence is directly measurable and improved. In the case of treatment resistant clozapine is the agent of choice, followed by electroconvulsive therapy, which also has the best evidence as augmentation treatment in cases of clozapine resistance. CONCLUSION: New therapeutic agents with improved efficacy and tolerability as well as effectiveness for negative symptoms and cognitive disturbance are needed.


Asunto(s)
Antipsicóticos , Esquizofrenia , Adulto , Antipsicóticos/uso terapéutico , Clozapina/uso terapéutico , Humanos , Olanzapina/uso terapéutico , Risperidona/uso terapéutico , Esquizofrenia/tratamiento farmacológico
2.
Expert Opin Pharmacother ; 21(3): 253-260, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31957501

RESUMEN

Introduction: Lurasidone has been approved in the United States as a monotherapy and adjunct for acute bipolar I depression, as well as an antipsychotic for patients with schizophrenia.Areas covered: Herein, the authors review the pharmacodynamics and pharmacokinetics of lurasidone as well and the major randomized clinical trials. The authors also provide their expert opinion.Expert opinion: Lurasidone has not been studied in patients with mania or bipolar psychosis. It has been studied, both as a monotherapy and adjunctive treatment to lithium or valproate, in acute depression and in prevention of recurrence of any mood episode in patients with bipolar disorder initially treated for bipolar depression or mania. It is approved in the United States for acute bipolar I depression. It has clinically meaningful treatment effect sizes for improvement in depression compared to placebo (0.51 monotherapy, 0.34 adjunct). The number needed to treat (NNT) for response with monotherapy was 5 (for both lower and higher dose groups), and for remission was 6 and 7 (for lower dose and higher dose groups, respectively); the NNT for adjunctive therapy was 7. It has not demonstrated efficacy in relapse prevention when added to a mood stabilizer but is safe in combination with other medications.


Asunto(s)
Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Clorhidrato de Lurasidona/uso terapéutico , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia , Ácido Valproico/uso terapéutico
4.
Nervenarzt ; 91(2): 107-113, 2020 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-31989210

RESUMEN

BACKGROUND: The development of delirium in patients with idiopathic Parkinson's disease (IPD) is a feared complication, which is often associated with sustained worsening of motor symptoms and psychopathological sequelae. Little is known regarding the prevalence and incidence rates, course and prognosis. Clinical studies from which recommendations for evidence-based management of delirium in IPD can be derived are lacking. OBJECTIVE: To summarize the state of the art regarding epidemiological and clinical features of delirium in IPD. Discussion of prevention strategies and non-pharmacological and pharmacological treatment options. METHODS: A literature search was carried out in PubMed. RESULTS: The IPD is an independent risk factor for the development of delirium. Patients with IPD show poorer clinical outcome frequently with cognitive worsening and motor complications following development of delirium. CONCLUSION: So far no validated rating scales for recognition and course evaluation of delirium in IPD are available. Preventive strategies and non-pharmacological measures should be consistently implemented to improve management. There are insufficient data concerning pharmacotherapy with quetiapine and clozapine, whereas other neuroleptics are contraindicated for delirium in IPD due to antidopaminergic side effects.


Asunto(s)
Antipsicóticos , Clozapina , Delirio , Enfermedad de Parkinson , Antipsicóticos/uso terapéutico , Clozapina/uso terapéutico , Delirio/tratamiento farmacológico , Delirio/etiología , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Factores de Riesgo
5.
Psychiatr Prax ; 47(1): 43-45, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31284315

RESUMEN

Hypersexual behavior can be assumed as a rare side effect of treatment with aripiprazole and is possibly due to partial agonism on dopamine receptors or partial agonism on 5-HT1A receptors and 5 HT2A antagonism.


Asunto(s)
Antipsicóticos , Aripiprazol , Conducta Sexual , Disfunciones Sexuales Psicológicas/inducido químicamente , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Aripiprazol/efectos adversos , Aripiprazol/uso terapéutico , Alemania , Humanos , Receptor de Serotonina 5-HT1A , Receptor de Serotonina 5-HT2A , Antagonistas del Receptor de Serotonina 5-HT2 , Disfunciones Sexuales Psicológicas/psicología
7.
Lancet Psychiatry ; 7(1): 64-77, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31860457

RESUMEN

BACKGROUND: Antipsychotic treatment is associated with metabolic disturbance. However, the degree to which metabolic alterations occur in treatment with different antipsychotics is unclear. Predictors of metabolic dysregulation are poorly understood and the association between metabolic change and change in psychopathology is uncertain. We aimed to compare and rank antipsychotics on the basis of their metabolic side-effects, identify physiological and demographic predictors of antipsychotic-induced metabolic dysregulation, and investigate the relationship between change in psychotic symptoms and change in metabolic parameters with antipsychotic treatment. METHODS: We searched MEDLINE, EMBASE, and PsycINFO from inception until June 30, 2019. We included blinded, randomised controlled trials comparing 18 antipsychotics and placebo in acute treatment of schizophrenia. We did frequentist random-effects network meta-analyses to investigate treatment-induced changes in body weight, BMI, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, and glucose concentrations. We did meta-regressions to examine relationships between metabolic change and age, sex, ethnicity, baseline weight, and baseline metabolic parameter level. We examined the association between metabolic change and psychopathology change by estimating the correlation between symptom severity change and metabolic parameter change. FINDINGS: Of 6532 citations, we included 100 randomised controlled trials, including 25 952 patients. Median treatment duration was 6 weeks (IQR 6-8). Mean differences for weight gain compared with placebo ranged from -0·23 kg (95% CI -0·83 to 0·36) for haloperidol to 3·01 kg (1·78 to 4·24) for clozapine; for BMI from -0·25 kg/m2 (-0·68 to 0·17) for haloperidol to 1·07 kg/m2 (0·90 to 1·25) for olanzapine; for total-cholesterol from -0·09 mmol/L (-0·24 to 0·07) for cariprazine to 0·56 mmol/L (0·26-0·86) for clozapine; for LDL cholesterol from -0·13 mmol/L (-0.21 to -0·05) for cariprazine to 0·20 mmol/L (0·14 to 0·26) for olanzapine; for HDL cholesterol from 0·05 mmol/L (0·00 to 0·10) for brexpiprazole to -0·10 mmol/L (-0·33 to 0·14) for amisulpride; for triglycerides from -0·01 mmol/L (-0·10 to 0·08) for brexpiprazole to 0·98 mmol/L (0·48 to 1·49) for clozapine; for glucose from -0·29 mmol/L (-0·55 to -0·03) for lurasidone to 1·05 mmol/L (0·41 to 1·70) for clozapine. Greater increases in glucose were predicted by higher baseline weight (p=0·0015) and male sex (p=0·0082). Non-white ethnicity was associated with greater increases in total cholesterol (p=0·040) compared with white ethnicity. Improvements in symptom severity were associated with increases in weight (r=0·36, p=0·0021), BMI (r=0·84, p<0·0001), total-cholesterol (r=0·31, p=0·047), and LDL cholesterol (r=0·42, p=0·013), and decreases in HDL cholesterol (r=-0·35, p=0·035). INTERPRETATION: Marked differences exist between antipsychotics in terms of metabolic side-effects, with olanzapine and clozapine exhibiting the worst profiles and aripiprazole, brexpiprazole, cariprazine, lurasidone, and ziprasidone the most benign profiles. Increased baseline weight, male sex, and non-white ethnicity are predictors of susceptibility to antipsychotic-induced metabolic change, and improvements in psychopathology are associated with metabolic disturbance. Treatment guidelines should be updated to reflect our findings. However, the choice of antipsychotic should be made on an individual basis, considering the clinical circumstances and preferences of patients, carers, and clinicians. FUNDING: UK Medical Research Council, Wellcome Trust, National Institute for Health Research Oxford Health Biomedical Research Centre.


Asunto(s)
Antipsicóticos , Metabolismo de los Lípidos/efectos de los fármacos , Metaanálisis en Red , Esquizofrenia , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Glucemia/efectos de los fármacos , Índice de Masa Corporal , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Esquizofrenia/tratamiento farmacológico , Esquizofrenia/fisiopatología , Aumento de Peso/efectos de los fármacos
8.
Artículo en Ruso | MEDLINE | ID: mdl-31793547

RESUMEN

Antipsychotics are used in the treatment of schizophrenia and other psychoses, as well as bipolar disorder, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and specific types of personality disorders. Due to better tolerability, as well as some advantages of the pharmacological profile, the second-generation antipsychotics are preferred in clinical practice. A special place among antipsychotics is taken by sulpiride, which shows the ability to improve the condition of patients with different types of mental disorders as well as with internal diseases.


Asunto(s)
Antipsicóticos , Trastorno Bipolar , Trastorno Obsesivo Compulsivo , Trastornos Psicóticos , Esquizofrenia , Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Humanos , Trastorno Obsesivo Compulsivo/tratamiento farmacológico , Trastornos Psicóticos/tratamiento farmacológico , Esquizofrenia/tratamiento farmacológico
9.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(11): 123-127, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31851183

RESUMEN

The more frequent prescription of antipsychotics with high proportion of off label use, in particular for children and adolescents, is seen in many countries, including European Union, United States and Russian Federation. In accordance to current clinical guidelines, second-generation antipsychotics are preferred in clinical practice due to the higher tolerability compared to the first-generation antipsychotics. However, second-generation antipsychotics in children and adolescents, especially in continuous use, are associated with cardiac abnormalities and metabolic disorders, including hyperglycemia, and the risk of type 2 diabetes, weight gain and obesity, an increase in prolactin synthesis and hyperlipidemia. The adverse effects of antipsychotics in children and adolescents determine the need for more balanced approaches to their use, careful monitoring of the safety of treatment and the development of measures to prevent and correct side-effects of these drugs.


Asunto(s)
Antipsicóticos , Adolescente , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Niño , Diabetes Mellitus Tipo 2/inducido químicamente , Humanos , Obesidad , Federación de Rusia , Aumento de Peso
10.
J Opioid Manag ; 15(5): 362-366, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31849027

RESUMEN

OBJECTIVE: To assess the efficacy of buprenorphine augmentation in treatment of psychotic symptoms in bipolar disorder type I. DESIGN: Bipolar type I patients with manic or depressive episodes and psychotic feature and with opioid dependency comorbidity were randomly included and allocated. Both groups of buprenorphine (4 or 6 mg/d) and placebo were also treated with enough dosages of sodium valproate and risperidone. Psychosis as primary outcome and depressive and manic symptoms as secondary outcome were assessed at baseline and after 1 and 2 weeks. Data were analyzed through t test and repeated measure ANOVA. RESULTS: Twenty-four patients remained in each group. Both groups displayed significant reduction in psychotic, depressive, and manic symptoms during the 2 weeks of study, although there was not any significant difference between them. CONCLUSIONS: Buprenorphine did not add any efficacy to usual treatment of psychotic episodes of bipolar, although did not aggravate psychiatric symptoms.


Asunto(s)
Antipsicóticos , Trastorno Bipolar , Buprenorfina , Trastornos Psicóticos , Analgésicos Opioides , Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Buprenorfina/uso terapéutico , Método Doble Ciego , Humanos , Trastornos Psicóticos/tratamiento farmacológico , Resultado del Tratamiento
11.
Nurs Clin North Am ; 54(4): 595-608, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31703784

RESUMEN

Antipsychotics can be life changing, but like all medications, they can also have unwanted effects, including drug-induced movement disorders such as tardive dyskinesia (TD). More patients are receiving antipsychotic treatment from non-psychiatry health care providers, including primary care and general practitioners. Despite misconceptions to the contrary, recent analyses suggest that the risk of drug-induced movement disorders such as TD has not been eliminated. Nurses across all care settings will increasingly encounter patients treated with antipsychotics. Nurses are critical for ensuring that patients exposed to antipsychotics receive screening and monitoring, care, and education.


Asunto(s)
Antipsicóticos/efectos adversos , Rol de la Enfermera , Discinesia Tardía/inducido químicamente , Discinesia Tardía/diagnóstico , Antipsicóticos/uso terapéutico , Humanos
12.
Expert Opin Pharmacother ; 20(17): 2063-2072, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31644326

RESUMEN

Introduction: Cariprazine, a D3-preferring, dopamine D2/D3 partial agonist, has efficacy in treating both acute phases of bipolar I disorder (BD-I). It has been approved by the FDA for treatment of acute manic, mixed and depressive episodes associated with BD-I.Areas covered: In this review, the authors discuss the unique pharmacological properties and clinical efficacy profile of cariprazine, and their relevance in the context of routine clinical decision-making for BD-I. For the purpose of this review, the authors searched for clinical trials in BD published in the PubMed, Web of Science, Embase and PsychInfo databases as well as for studies registered in the ClinicalTrials.gov database.Expert opinion: Based on evidence from RCTs in manic and mixed episodes, cariprazine in a dose-range of 3-12 mg is effective for treating acute mania and mixed states associated with BD-I. Importantly, evidence from placebo-controlled trials in bipolar depression suggests that cariprazine is also effective as a monotherapy in treating acute bipolar depression in doses of 1.5-3 mg/day. It is overall well tolerated; however, clinicians need to monitor patients for akathisia.


Asunto(s)
Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Piperazinas/uso terapéutico , Antipsicóticos/efectos adversos , Antipsicóticos/farmacocinética , Ensayos Clínicos como Asunto , Bases de Datos Factuales , Agonistas de Dopamina/efectos adversos , Semivida , Humanos , Piperazinas/efectos adversos , Piperazinas/farmacocinética , Resultado del Tratamiento
15.
Medicine (Baltimore) ; 98(40): e17375, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577741

RESUMEN

Achieving abstinence in schizophrenic smokers using a combination of medications and cognitive behavioral therapy is feasible; however, abstinence rates are significantly lower compared to the general population and studies are scanty. Additionally, maintaining sustained abstinence and preventing relapse is a major limiting factor and represents key tasks in managing tobacco dependence in schizophrenic patients. Several theories have been postulated to explain the higher tendency of tobacco use among schizophrenic individuals. Schizophrenic patients may use nicotine as a "self-medication" strategy to improve negative symptoms of schizophrenia. However, studies suggest that although nicotine may act as an anxiolytic acutely, chronic use of nicotine may lead to increased anxiety with the possibility of increased catecholamines, which is confirmed with the prevalence of tachycardia and hypertension in smokers in general. On this basis, the main objective of our present study was to assess anxiety in schizophrenic smoking and nonsmoking patients by comparing the number of anxiety and agitation episodes and evaluating the amount of antianxiety/antiagitation medication used by each group. A separate objective was to document the unmet needs of smoking cessation programs in treating schizophrenic patients. Consequently, in the present retrospective cohort study, it was observed that schizophrenic smokers tend to have higher anxiety episodes and utilize as-needed medications at a higher frequency compared to nonsmokers for the relief of anxiety and agitation symptoms. Further research is warranted to examine these results on a larger scale.


Asunto(s)
Ansiedad/epidemiología , Fumar Cigarrillos/epidemiología , Esquizofrenia/epidemiología , Ansiolíticos/uso terapéutico , Antipsicóticos/uso terapéutico , Ansiedad/tratamiento farmacológico , Femenino , Humanos , Masculino , Estudios Retrospectivos , Esquizofrenia/tratamiento farmacológico , Fumadores , Cese del Hábito de Fumar/métodos
18.
Medicine (Baltimore) ; 98(38): e17237, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31567988

RESUMEN

INTRODUCTION: With the second-generation antipsychotics (SGAs) widely applied to treat patients with schizophrenia, adverse effects, especially the metabolic syndrome (MetS), were paid more attention following by the efficacy of SGAs. Several studies have suggested that acupuncture could be an effective and safe intervention for MetS. Here, we present a study protocol to investigate the effect of electroacupuncture on MetS due to olanzapine and risperidone. METHODS: This study is a prospective, randomized, single-centered, patient-assessor-blinded, parallel-controlled clinical pilot trial. In all, 36 patients will be randomized to an experimental group or control group by a 1:1 ratio. All patients will receive lifestyle interventions. The experimental group will receive electroacupuncture treatment. The control group will receive sham electroacupuncture treatment. The primary outcomes are body mass index (BMI) and waist circumference (WC). The secondary outcome measures include blood pressure (BP), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), leptin, and adiponectin. We will assess at baseline, 8 weeks after intervention and at the end of 3 months' follow-up. DISCUSSION: The results of this trial are expected to provide data on the efficacy and safety of electroacupuncture on MetS due to olanzapine and risperidone, and potential biochemical mechanism.


Asunto(s)
Antipsicóticos/efectos adversos , Electroacupuntura , Síndrome Metabólico/terapia , Olanzapina/efectos adversos , Risperidona/efectos adversos , Antipsicóticos/uso terapéutico , Protocolos Clínicos , Electroacupuntura/efectos adversos , Electroacupuntura/métodos , Humanos , Síndrome Metabólico/inducido químicamente , Olanzapina/uso terapéutico , Risperidona/uso terapéutico , Esquizofrenia/tratamiento farmacológico
19.
Actas esp. psiquiatr ; 47(5): 190-201, sept.-oct. 2019. graf, tab
Artículo en Español | IBECS | ID: ibc-185171

RESUMEN

El trastorno esquizoafectivo (TEA) es un trastorno psicótico que ha entrañado cierta controversia nosológica, junto a esta dificultad encontramos muy pocos estudios que aborden su tratamiento como una entidad diferente a la esquizofrenia. Estas dos dificultades dan como resultado la falta de evidencia específica sobre el tratamiento. Actualmente, el mismo, se basa principalmente en el empleo de antipsicóticos, aunque no existen guías específicas de manejo terapéutico. Esta revisión tiene el objetivo de conocer cuáles son los fármacos que actualmente cuentan con estudios de mayor calidad científica que avalen su empleo según variables clínicas de efectividad, seguridad, adherencia y tolerancia, así como su papel en los diferentes subtipos de TEA y situaciones clínicas. Para ello, se realizó una revisión exhaustiva de estudios experimentales y observacionales que incluyeran pacientes con diagnóstico de TEA. Se concluyó que son necesarios más ensayos clínicos realizados en pacientes con diagnóstico exclusivo de TEA. La paliperidona, el único fármaco con uso autorizado en el TEA es el fármaco que cuenta con mayor cantidad y calidad de estudios que avalen su uso. Risperidona, olanzapina, aripiprazol y ziprasidona también tienen ensayos clínicos aleatorizados que apoyan su eficacia y seguridad. En pacientes refractarios, hay estudios observacionales que señalan la utilidad de la clozapina. Así mismo, hay evidencia de estudios observacionales que señalan la utilidad de litio y carbamazepina durante la fase de mantenimiento. Es necesario establecer el papel del tratamiento combinado con regula-dores del humor y/o antidepresivos


Schizoaffective disorder (SAD) is a psychotic disorder which has presented a certain nosological controversy. Apart from these difficulties, very few studies focused in SAD as a distinct condition from schizophrenia have been found. This lack of specifical studies on SAD results in a lack of specific evidence about treatment. Currently, its treatment is based mainly on the use of antipsychotics, although there are no specific treatment guidelines for SAD. The objective of this review is to establish which are the most recommended treatments according to evidence avail-able, considering clinical variables such as efficacy, safety, adherence, and tolerance as well as the role of these factors in different subtypes of SAD. This exhaustive review exam-ines experimental and observational studies involving patients with a diagnosis of SAD. It was concluded that more clinical trials performed exclusively on patients affected by SAD are needed. Paliperidone, the only drug with authorized use in SAD, is the one that has the highest quality of studies to support its use. Risperidone, olanzapine, aripiprazole and ziprasidone also have randomized clinical trials supporting their efficacy and safety. In treatment-refractory patients, there are observational studies indicating the usefulness of clozapine. Like-wise, there is evidence from observational studies showing the usefulness of lithium and carbamazepine during the treatment maintenance phase. It is necessary to establish the role of combined treatment with mood stabilizers and/or antidepressants


Asunto(s)
Humanos , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Psicofarmacología , Resultado del Tratamiento , Medicina Basada en la Evidencia , Trastornos Psicóticos/tratamiento farmacológico , Risperidona/uso terapéutico , Olanzapina/uso terapéutico , Aripiprazol/uso terapéutico , Clozapina/uso terapéutico , Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico
20.
Tidsskr Nor Laegeforen ; 139(13)2019 Sep 24.
Artículo en Noruego, Inglés | MEDLINE | ID: mdl-31556524

RESUMEN

BACKGROUND: Norwegian national guidelines recommend that clozapine be offered to patients with schizophrenia after two failed attempts with other antipsychotic drugs. One of the main objectives for the introduction of clinical pathways in mental health care is to provide an equal service to patients irrespective of where in the country they live. We wished to investigate the prescribing level of clozapine in various Norwegian counties. MATERIAL AND METHOD: We retrieved aggregated data from the Norwegian Prescription Database, the Norwegian Patient Registry and Statistics Norway on prescribing of clozapine, number of patients in contact with the specialist health service with the diagnosis schizophrenia, and population figures for 2016. RESULTS: Nationwide in 2016, there were 50 users of clozapine per 100 000 inhabitants (95 % confidence interval (CI) 48-52). The number of users was highest in Troms county (76 (95 % CI 63-89) per 100 000 inhabitants) and lowest in Akershus county (38 (95 % CI 33-43) per 100 000 inhabitants). We found no significant correlation between the prescribing rate for clozapine and the proportion of the population in the county who were undergoing treatment for schizophrenia in the specialist health service. INTERPRETATION: Prescribing of clozapine varies among Norwegian counties and is not correlated with the proportion of the population who are undergoing treatment for schizophrenia in the specialist health service. Different levels of implementation of the national guidelines constitute a possible explanation for the geographic differences.


Asunto(s)
Antipsicóticos/administración & dosificación , Clozapina/administración & dosificación , Prescripciones de Medicamentos/estadística & datos numéricos , Utilización de Medicamentos/estadística & datos numéricos , Esquizofrenia/tratamiento farmacológico , Adulto , Anciano , Antipsicóticos/uso terapéutico , Clozapina/uso terapéutico , Bases de Datos Factuales , Femenino , Adhesión a Directriz , Humanos , Masculino , Persona de Mediana Edad , Noruega , Guías de Práctica Clínica como Asunto , Sistema de Registros , Adulto Joven
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