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Does a history of suicide attempt predict higher antipsychotic dosage in schizophrenia?

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Abstract

Rationale

Antipsychotic dosage is generally adjusted by physicians depending on the stability of the patient and the response to that particular drug. Our hypothesis is that patients with previous suicide attempt are prescribed higher doses of antipsychotics.

Objective

We examined the dosage and patterns of antipsychotic use in regard to past suicidal behaviour.

Methods

For this study, 304 subjects with schizophrenia spectrum disorders between the ages of 18 and 75 were recruited. A cross-sectional assessment was used for this study, in which data were collected from each patient through an interview and self-report questionnaires. The percentages of the Compendium of Pharmaceuticals and Specialties (CPS) maximum recommended daily dose were applied to standardize antipsychotic dosages across different treatments. We compared the standardized dosage of antipsychotics in schizophrenics with previous suicide attempts and those who have never attempted suicide.

Results

Applying the ANCOVA, our preliminary results show no significant difference (P = 0.467) in antipsychotic dosage in the attempters and non-attempters. The prescribed clozapine dosage fails to show a significant relationship with suicidal history (P >0.05).

Conclusions

In summary, our analysis does not show antipsychotic dosage adjustment based on past suicide attempt, after controlling for the current suicidal ideation and hopelessness.

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Acknowledgments

This study was supported by an operating grant from CIHR.

Conflict of Interest

None.

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Authors and Affiliations

  1. Group for Suicide Studies, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada

    Nuwan C. Hettige & Vincenzo De Luca

  2. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

    James L. Kennedy & Vincenzo De Luca

Authors
  1. Nuwan C. Hettige
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  2. James L. Kennedy
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  3. Vincenzo De Luca
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Correspondence to Vincenzo De Luca.

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Hettige, N.C., Kennedy, J.L. & De Luca, V. Does a history of suicide attempt predict higher antipsychotic dosage in schizophrenia?. Psychopharmacology 231, 2507–2513 (2014). https://doi.org/10.1007/s00213-013-3419-8

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  • DOI: https://doi.org/10.1007/s00213-013-3419-8

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