First-Time Patients with Psychosis Often Receive Wrong Drugs

By John Lavitt 01/16/15

A new study revealed how first-time patients saw a bad situation turned worse by their own doctors.

Man taking pill

The National Institute of Mental Health released the results of a surprising new study showing that nearly 40% of first-time patients diagnosed with psychosis receive the wrong medications from their doctors.

In their wide-ranging national analysis, the scientists found that such wrong medications often worsen the symptoms of the patients. When doctors treat patients for a first episode of psychosis, like a schizophrenic break, guidelines call for therapies vastly different and more controlled from those prescribed to people with a history of multiple episodes.

Despite the more careful guidelines for first-timers, the study revealed that such rules often are not followed. After examining the cases 400 mental health patients (ages 15 to 40) who experienced their first episode and sought treatment at 34 community-based clinics in 21 states, the high percentage of wrong drugs prescribed and the resulting negative outcomes proved disturbing. Effective medication treatment from the get go, particularly strategies minimizing side effects, would lead to better results for beleaguered patients.

To improve prescription practices, the study authors recommend additional education for local physicians and community-based clinics prescribing medication for such patients. As one of the leaders of the study, Dr. Delbert Robinson of the Center for Psychiatric Neuroscience at the Feinstein Institute for Medical Research explained. “The challenge for the field is to develop ways to transmit the specialized knowledge about first-episode treatment to busy community clinicians," Robinson said.

A major goal of the report is to teach doctors how to be less aggressive when treating the condition in first-time patients. The results found that 40% of the study participants would have benefited enormously if they had been prescribed different medications.

Since community mental health clinicians usually have extensive experience treating individuals with multi-episode psychosis, they tend to prescribe a more potent drug cocktail to people with a first-episode diagnosis. Of the 159 patients studied by Kane and Robinson, many fell into multiple categories of medication mismanagement.

According to the study's findings, more than 8% were prescribed higher-than-recommended doses of antipsychotic drugs; 23% were prescribed more than one antipsychotic drug; nearly 37% were prescribed an antipsychotic and an antidepressant without a clear need for the antidepressant; and 1.2% were inappropriately prescribed stimulants.

Even worse, more than a third of the patients were prescribed Olanzapine, a hardcore medication not recommended for patients with first-episode psychosis. If the study and the guidelines instituted nationally are not heeded, the result will only be more unnecessary suffering for the patients.

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.