ArticleBMJ open2021
Prescribing pattern of antipsychotic medication for first-episode psychosis: a retrospective cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical Practice Guideline on the Choice of First Antipsychotic Medicine for Females Experiencing a First-Episode of Psychosis.Schizophrenia bulletin · 2026Guideline
- Duration of Untreated Psychosis and Outcomes in First-Episode Psychosis: Systematic Review and Meta-analysis of Early Detection and Intervention Strategies.Schizophrenia bulletin · 2024Pooled it
- Predicting antipsychotic-induced weight gain in first episode psychosis - A field-wide systematic review and meta-analysis of non-genetic prognostic factors.European psychiatry : the journal of the Association of European Psychiatrists · 2023Pooled it
- Use of antipsychotic medication with weight-inducing potential in first-episode psychosis.Frontiers in psychiatry · 2026Article
- Evaluation of Prescription Patterns of Antipsychotics in Schizophrenia Patients-A Single-Center Prospective Study.Journal of clinical medicine · 2025Article
- Borderline personality disorder vs. schizophrenia spectrum disorders in young people recruited within an "Early Intervention in Psychosis" service: clinical and outcome comparisons.European archives of psychiatry and clinical neuroscience · 2025Article
- Pharmacist-led Si-care (schizophrenia care) model to improve medication adherence and symptom management in schizophrenia.Exploratory research in clinical and social pharmacy · 2024Article
- Clinical effects of CYP2D6 phenoconversion in patients with psychosis.Journal of psychopharmacology (Oxford, England) · 2024Article
- Development and Validation of a Machine Learning-Based Model of Mortality Risk in First-Episode Psychosis.JAMA network open · 2024Article
- Article
- Unraveling ethnic disparities in antipsychotic prescribing among patients with psychosis: A retrospective cohort study based on electronic clinical records.Schizophrenia research · 2023Article
- Oral and long-acting injectable antipsychotic discontinuation and relationship to side effects in people with first episode psychosis: a longitudinal analysis of electronic health record data.Therapeutic advances in psychopharmacology · 2023Article
- Minding metabolism: targeted interventions to improve cardio-metabolic monitoring across early and chronic psychosis.Irish journal of medical science · 2022Article
- Effect of aripiprazole as an adjunct to atypical antipsychotics on weight and metabolic profile: a 12-week open-label trial.Therapeutic advances in psychopharmacology · 2021Article
- Worth the Weight? Olanzapine Prescribing in Schizophrenia. A Review of Weight Gain and Other Cardiometabolic Side Effects of Olanzapine.Frontiers in psychiatry · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveGuidelines for antipsychotic use in first-episode psychosis (FEP) recommend that medication be chosen initially on the basis of side effect profile with doses at the lower end of the range. Our objective was to describe the pattern of antipsychotic use in FEP over a period of 21 years in the context of changing clinical guidelines and the development of specialist early intervention in psychosis (EIP) services.
settingA community-based mental health service in South County Dublin (population 187 000) and a large private hospital.
participantsParticipants included 465 patients with FEP (146 from an epidemiological study (1995-1999) and 319 from a specialist EIP service (2005-2016)). Treatment with antipsychotic medication did not exceed 30 days at study entry. OUTCOME MEASURES: This is a descriptive study of prescribing practices in the context of service development and changing guidelines.
resultsFirst-generation antipsychotics were prescribed for 65% of the early cohort compared with 4.3% of the EIP cohort. Olanzapine was initially prescribed for 79.7% of EIP patients. Initial doses of medication were frequently low (≤50% British National Formulary (BNF) maximum) in both cohorts (71% and 78.6%). The demographic and clinical factors investigated did not influence the initial choice of antipsychotic medication significantly. Univariate logistic regression analysis suggested inpatient treatment setting was associated with a higher initial dose (>50% BNF maximum) of antipsychotic medication. Increasing dose requirements over the first month of engagement with an EIP service was associated with poorer global functioning at baseline, greater positive symptoms at baseline and the inpatient treatment setting. However, these associations were not seen in the multivariable model.
conclusionsSecond-generation antipsychotic prescribing predominates, but guidelines are often overlooked when choosing olanzapine notwithstanding lower initial dosages. EIP services should include proactive support for optimising medicines in line with evidence-based guidelines.
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