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Tungaraza TE, Ahmed W, Chira C, et al. Prescribing pattern of clozapine and other antipsychotics for patients with first-episode psychosis: a cross-sectional survey of early intervention teams. Ther Adv Psychopharmacol. 2016;7(3):103-111doi: 10.1177/2045125316683151.
Tungaraza, T. E., Ahmed, W., Chira, C., Turner, E., Mayaki, S., Nandhra, H. S., Edwards, T., & Farooq, S. (2017). Prescribing pattern of clozapine and other antipsychotics for patients with first-episode psychosis: a cross-sectional survey of early intervention teams. Therapeutic advances in psychopharmacology, 7(3), 103-111. https://doi.org/10.1177/2045125316683151
Tungaraza, Tongeji E, et al. "Prescribing pattern of clozapine and other antipsychotics for patients with first-episode psychosis: a cross-sectional survey of early intervention teams." Therapeutic advances in psychopharmacology vol. 7,3 (2017): 103-111. doi: https://doi.org/10.1177/2045125316683151
Tungaraza TE, Ahmed W, Chira C, Turner E, Mayaki S, Nandhra HS, Edwards T, Farooq S. Prescribing pattern of clozapine and other antipsychotics for patients with first-episode psychosis: a cross-sectional survey of early intervention teams. Ther Adv Psychopharmacol. 2017 Mar;7(3):103-111. doi: 10.1177/2045125316683151. Epub 2016 Dec 01. PMID: 28348730; PMCID: PMC5354130.
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Ther Adv Psychopharmacol. 2017 Mar;7(3):103-111. doi: 10.1177/2045125316683151. Epub 2016 Dec 01.

Prescribing pattern of clozapine and other antipsychotics for patients with first-episode psychosis: a cross-sectional survey of early intervention teams.

Therapeutic advances in psychopharmacology

Tongeji E Tungaraza, Wakil Ahmed, Chinonyelum Chira, Erin Turner, Susan Mayaki, Harpal Singh Nandhra, Tom Edwards, Saeed Farooq

Affiliations

  1. Consultant General Adult Psychiatrist (Rehabilitation), Partnerships in Care Ltd., Beverley House, 527-529 City Road, Birmingham, B617 8LL (Formerly Consultant EIS, Wolverhampton), UK.
  2. Consultant General Adult Psychiatrist, MHHTT, Park House, North Manchester, Manchester Mental Health & Social Care Trust, UK.
  3. Consultant in Child and Adolescent Psychiatry, Birmingham Children's Hospital, UK.
  4. Consultant Solihull Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, UK.
  5. Consultant General Adult Psychiatrist, Assertive Outreach Team, and Rehabilitation, Hereford, UK.
  6. Consultant Psychiatrist, C&W Partnership Trust. Ashton house, Leamington Spa, UK.
  7. Consultant Psychiatrist, Dudley and Walsall Mental Health Partnership NHS Trust, Walsall Assertive Outreach Team and Walsall North Community Recovery Service, Dorothy Pattison Hospital, Alumwell Close, Walsall, West Midlands, UK.
  8. Clinical Senior Lecturer, Research Institute for Primary Care & Health Sciences, Keele University, UK Honorary Consultant Psychiatrist, South Staffordshire and Shropshire NHS Foundation Trust, UK.

PMID: 28348730 PMCID: PMC5354130 DOI: 10.1177/2045125316683151

Abstract

OBJECTIVE: To describe the pattern of antipsychotic drug prescribing in patients with first episode psychosis, with more emphasis in the use of clozapine in this group of patients.

METHOD: A cross-sectional survey involving six early intervention service (EIS) teams in the West Midlands was conducted. Data was extracted from case notes and electronic records by clinicians working in each participating team. The pattern of antipsychotic prescribing and the changes that took place after being accepted in EIS, including the use of clozapine, was established. Clinicians involved in the treatment of patients in each team rated the overall clinical response to treatment based on the presence or absence of positive psychotic symptoms.

RESULT: 431 patients with FEP were included in the final analysis. Low antipsychotic discontinuation rate was observed, with the majority (88.2%) still being prescribed antipsychotics. Most (77.3%) were prescribed second-generation antipsychotic drugs, with olanzapine (21.8%) and aripiprazole (19.7%) being the most frequently prescribed antipsychotics. There was low rate use of antipsychotic combinations (7.4%), high dose antipsychotic regime (3.9%), low depot antipsychotic prescribing (9.3%), and clozapine use was low (9.7%). On average, three antipsychotics were tried before clozapine was initiated and it took on average 19.5 months from being accepted into EIS to clozapine being initiated.

CONCLUSION: The majority of patients were prescribed antipsychotics within the guidelines. EIS was associated with an overall low antipsychotic discontinuation. There was also a short waiting time before clozapine was initiated following patients being accepted into EIS.

Keywords: antipsychotics; clozapine; cross-sectional survey; first-episode psychosis

Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

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