Magazine article Clinical Psychiatry News

Wait 6-8 Weeks before Switching Antipsychotics. (Don't Give Up Too Soon)

Magazine article Clinical Psychiatry News

Wait 6-8 Weeks before Switching Antipsychotics. (Don't Give Up Too Soon)

Article excerpt

SAN FRANCISCO -- Psychiatrists need to be a little more patient when treating first episodes or acute exacerbations of schizophrenia, Dr. Ira D. Glick said.

Too many clinicians give up on an antipsychotic too soon and switch medications before 6-8 weeks of use, which is the amount of time needed for an adequate treatment trial, he said at an industry-sponsored symposium at the annual meeting of the American Psychiatric Association.

"This is a major problem that I've seen around the country-people switching too soon," he said.

Incomplete responses are the norm in schizophrenia; patients almost never return to their baseline level of functioning regardless of the antipsychotic used. "You've got to resist pressures from families, nurses, and payers" to switch treatments in hopes of a better response in many cases, he added.

A recent study provides some gnidance for clinicians who want to switch a schizophrenic patient to the newest antipsychotic, aripiprazole (Abilify), which was approved in late 2002. Any of three strategies for switching worked equally well in a randomized study of 298 patients to be published soon in the Journal of Clinical Psychopharmacology: starting aripiprazole and tapering the old drug, stopping the old drug immediately and starting aripiprazole, or tapering the old drug while titrating up the dose of aripiprazole. …

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