Strategies for dosing and switching antipsychotics for optimal clinical management.

摘要: Optimal clinical management of schizophrenia and bipolar disorder can be achieved through careful antipsychotic dosing and, if necessary, switching to another well-chosen using suitable strategies. For severely ill patients treated in practice, adequate may not result from following the relatively low levels abrupt titration schedules typically used registration trials. Data recent effectiveness trials, naturalistic studies, Roadmap Expert Consensus Survey provide evidence specific dose for agents that appropriate practice. Discontinuation frequent medication are common among with antipsychotics, but data suggest an trial first should undertaken before medication. Making a decision switch typical atypical or between antipsychotics involve consideration variables relating patient, illness, medication, patient's environment. Switching improve efficacy tolerability also predictable side effects withdrawal symptoms, including weight gain metabolic as well associated prolactin changes. Many occur during attributable receptor profiles antimuscarinic antihistaminic blockade. Individualized strategies include choice dose, tapering schedules; symptoms; patient psychoeducation reduce treat effects, increasing likelihood successful greater adherence efficacy.