The naturalistic use of antipsychotics in early psychosis in Hong Kong

Abstract

The current naturalistic study aims to examine the pattern of pharmaco-therapy in the first 3 years of treatment for psychotic disorders. Data were captured from medical records according to operationalized procedures. The sample includes 1400 patients who first presented to public mental health service from 1998 to 2003. Pattern of pharmacotherapy were ana-lyzed in two aspects: (1) switch of antipsychotics, (2) use of conventional and atypical antipsychotics. Results 1: In the first contact, clinician mostly prescribed Haloperidol (30.3%), Trifluoperazine (25.1%) and Sulpiride (11.4%), with a mean duration of 12.14 months (SD = 12.59). First switch of antipsychotics was mainly Risperidone (16.3%), Olanzapine (12.8%) and Sulpiride (12.8%), with a mean duration of 12.49 months (SD = 11.07). 56.5% of patients were having positive symptoms (mildly ill or severer) and 54.2% of patients got side effect (mild or severe) before the switch. Second switch of antipsychotics was mainly Olanzapine (15.2%), Sulpiride (13.7%) and Risperidone (10.0%), with a mean duration of 10.63 months (SD = 9.23). 48.9% of patients were having positive symptoms and 44.4% of patients got side effect before the switch. Results 2: Majority (55%) of the patients only took conventional antipsychotics in the first three years, whereas 24.8% of patients shifted to atypical from conventional. 10% of patients started their pharmacotherapy with atypical antipsychotics and maintained till the end of the 3 years. Conclusion: Conventional antipsy-chotics are still the dominant pharmacotherapy in the early phase of treat-ment. Olanzapine and Risperidone were the mostly prescribed atypical antipsychotics if the initial treatment was unsatisfactory.