Use of antipsychotic drugs. A multicentric study of inpatients with acute psychotic disorders.

Abstract

With the objective of determining the pattern and decision making process in using antipsychotic drugs in patients admitted to hospital for acute psychotic disorder we have made a retrospective analysis in 244 in-patients in 7 hospitals for mental disorders. We have selected two groups, IM and PO, that in the first three days of internment have received either intravenous antipsychotic medication or oral medication; the demographical, clinical and therapeutical differences have been considered (with a review of the cases at 6 and 12 months after discharge from hospital). Homogeneity was considered regarding age, race, gender, age at the onset of the disease and diagnosis; in the IM group there were a larger number of compulsive admissions. The most prevalent psychotic disorders in both groups were schizophrenia and bipolar disorder; with no association being made between the initial diagnosis and drug administration. The hospitalization period was the same for both groups, although in the patients in the IM group the need for special precautions was more frequent. Medication with anxiolytics was higher in the PO group on day 1 and 2 of the hospitalization and the same for the two groups on day 3 and on discharge. The number of new admissions, as well as the percentage of patients taking antipsychotic, anxiolytic and anticholinergic medication was similar in both groups after a period of 6 and 12 months follow-up. In this study, agitation and aggressive/destructive behaviours in the initial phase of hospitalization in the IM group (including the first contact, most of the times on admission at the ER) were statistically significant factors for the use of intramuscular administration of antipsychotic drugs.