Psychotropic medication use in youth at high risk for psychosis: Comparison of baseline data from two research cohorts 1998-2005 and 2008-2011

• Type of Material: Article
• Authors: Scott W. Woods, Yale University; Jean Addington, University of Calgary; Carrie E. Bearden, University of California, Los Angeles; Kristin S. Cadenhead, University of California, San Diego; Tyrone D. Cannon, Yale University; Barbara A. Cornblatt, Zucker Hillside Hospital; Daniel H. Mathalon, University of California, San Francisco; Diana O. Perkins, University of North Carolina System; Larry J. Seidman, Massachusetts General Hospital; Ming T. Tsuang, University of California, San Diego; Elaine Walker, Emory University; Thomas H. McGlashan, Yale University
• Language: English
• Date: 2013-08-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Elsevier B.V. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.schres.2013.05.019
• Title of Journal or Parent Work: Schizophrenia Research
• ISSN: 0920-9964
• Volume: 148
• Issue: 1-3
• Start Page: 99
• End Page: 104
• Grant/Funding Information: This study was supported by the National Institute of Mental Health (grants U01 MH066160 and U01 MH082022 to Dr Woods; grants U01 MH066134 and U01 MH081984 to Dr Addington; grants U01 MH060720, R01 MH60720, U01 MH082022 and K24 MH76191 to Dr Cadenhead; grants U01 MH065079 and MH081902 to Dr Cannon; grants U01 MH061523 and U01 MH081857 to Dr Cornblatt; grants U01 MH066069 and U01 MH082004 to Dr Perkins; grants U01 MH065562, U01 MH081928, P50 MH080272 and Commonwealth of Massachusetts SCDMH82101008006 to Dr Seidman; and grants U01 MH062066 to EFW and U01 MH081988 to Dr Walker).
• Keywords: Retrospective Studies; Adolescent; Humans; Cohort Studies; Statistics, Nonparametric; Antipsychotic medication; Female; Psychotropic Drugs; High risk; Risk syndrome; Prescriptions; Psychotropic medication; Risk; Psychotic Disorders; Antipsychotic Agents; Male; Psychosis; Chi-Square Distribution
• Research Categories: Health Sciences, Mental Health

Abstract

Background: Antipsychotic medication use rates have generally been rising among youth with psychiatric disorders, but little is known about use rates of antipsychotics or other psychotropic medications in patients at high risk for psychosis. Method: Baseline psychotropic medication use rates were compared in two research cohorts of patients at high risk for psychosis that enrolled between 1998-2005 (n. = 391) and 2008-2011 (n. = 346). Treatment durations and antipsychotic doses were described for cohort 2. Results: Median age was 17. years in cohort 1 and 18. years in cohort 2. The rate of prescription of any psychotropic at baseline was roughly 40% for each cohort. Antipsychotic prescription rates were 24% among sites that permitted baseline antipsychotic use in cohort 1 and 18% in the cohort 2; the decline did not quite reach statistical significance (p. = 0.064). In cohort 2 the mean. ±. SD baseline chlorpromazine-equivalent dose was 121. ±. 108. mg/d, and lifetime duration of antipsychotic treatment was 3.8. ±. 5.9. months. Discussion: Although the rate of antipsychotic prescription among high-risk youth may have fallen slightly, the nearly one-in-five rate in the second cohort still constitutes a significant exposure. Mitigating factors were that doses and durations of treatment were low. As for other nonpsychotic conditions, it is incumbent on our field to develop alternative treatments for high-risk patients and to generate additional evidence for or against the efficacy of antipsychotics to help define their appropriate role if alternative treatments fail.