RESEARCH – September 2008

Pharmacotherapy of first-episode psychosis in Estonia: comparison with national and international treatment guidelines


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BACKGROUND AND OBJECTIVES. The pharmacotherapy of psychosis often differs among countries and with respect to different treatment guidelines. The objective of the study was to analyse and describe the pharmacotherapy of first-episode psychosis in Estonia.
METHODS. Case records for consecutive patients with schizophrenia, and schizotypal or delusional disorders admitted to the psychiatry clinics of North Estonian Regional Hospital (NERH) and Tartu University Hospital (TUH) between September 2005 and September 2006 were retrospectively reviewed by a trained researcher. Treatment regimens were assessed according to prescribed doses, frequency of use of antipsychotic polypharmacy and prescribing of conventional versus atypical agents.
RESULTS. Altogether 234 patients had been admitted to NERH and TUH, 142 of whom were included in fi nal analysis (mean age 30.3 yrs for males, 40.4 yrs for females). The patients were most frequently treated with risperidone (n=94), olanzapine (n=43), chlorpromazine (n=31), haloperidol (n=21) and quetiapine (n=24). Fourteen patients received concurrent treatment with two or more antipsychotics for three or more treatment days. Nine patients received antipsychotics in doses exceeding maximum recommended doses.
CONCLUSIONS. The pharmacotherapy of first-episode psychoses in Estonia was largely consistent with Estonian and international guidelines, however, the use of conventional antipsychotics and antipsychotic polypharmacy has remained common. Estonian treatment guidelines may need revision to reflect the best available research evidence.