Study Finds Need for Improved Schizophrenia Care

Improper drug treatment is given to nearly 40 percent of people who suffer their first episode of schizophrenia, according to a new study.

Because schizophrenia is typically a chronic illness, early treatment can have an effect on a patient's long-term outcome, the researchers noted. Inappropriate drug treatment can lead to problems that cause patients to stop taking their medication.

The study included 404 people who suffered a first episode of schizophrenia. They were seen at community treatment centers in 21 states. Of those patients, 159 received drug treatment that was inconsistent with recommendations for first-episode patients.

Some of the more common mistakes the researchers cited included:

• Prescribing more than one antipsychotic drug.
• A higher-than-recommended dose of an antipsychotic.
• The use of psychotropic medication other than an antipsychotic.
• Prescribing an antidepressant without justification.
• The use of the antipsychotic olanzapine, which is especially likely to cause major weight gain but was often prescribed at high doses.

The study appears in The American Journal of Psychiatry.

"Academic research has found that optimal medication selection and dosing for first-episode patients differs from that for patients with longer illness durations. The challenge to the field is to get this specialized knowledge to busy clinicians who are treating patients," study author Dr. Delbert Robinson, a psychiatrist at the Zucker Hillside Hospital in Glen Oaks, N.Y., said in a journal news release.

"Our finding that treatment differed based upon patients' insurance status suggests that in order to improve first-episode care we may also need to address treatment system issues," Robinson said.

More information

The U.S. National Institute of Mental Health has more about schizophrenia.