World Fellowship for Schizophrenia And Allied Disorders
124 Merton Street, Suite 507, Toronto, On M4S 2Z2, Canada
Website: www.world-schizophrenia.org Email: [email protected]Some Pointers on Second Generation Antipsychotics Risperidone - commercial name: Risperdal- made by Janssen Dose range: 2-8 mg/day
J Less likely to cause weight gain; easy to adjust dose; not particularly sedating; possible
mood stabilizer; can be given once a day; available in liquid form; long-acting injectable preparation available soon; blood level testing available. Optimum dose range: 2-6 mg per day
L Increases prolactin (can cause menstrual irregularities, decreased libido, impotence,
etc.); more likely to cause muscle and movement side effects than other new medications.
Information on the web from the manufacturer Janssen: http://www.risperdal.com/ Risperidone depot – commercial name Risperdal Consta – made by Janssen Available 2004 in many countries
J For those who are forgetful of taking their medications or those who do not like to take
pills every day, this new medication may prove very useful. Depot medications provide the added benefit that the doctor knows that the patient is being treated and is alerted to non-adherence when the patient does not come for his injection. More about this new medication from the manufacturer at: www.risperdalconsta.com/ Olanzapine - commercial name: Zyprexa– made by Eli Lilly Dose range: 10-20 mg/day:
J Easy to adjust dose; sedating (good for insomnia); good mood stabilizer; can be given
once a day; available in rapidly dissolving tablet (Zydis)’ short-acting injectable form available soon, long-acting in a year or two; blood level testing available.
L High risk of weight gain regardless of dose; 40% increase 7% of their body weight; this
is usually seen in the first 2 – 4 weeks; likely increased risk of glucose intolerance / diabetes.
Information on the web from the manufacturer Eli Lilly: http://www.zyprexa.com/index.jsp Quetiapine - commercial name Seroquel– made by AstraZeneca Dose range: 300 – 750 mg/day
J Somewhat sedating; no risk of muscle / movement side effects; modest risk of weight
gain; generally very well tolerated; often given once a day
L Difficult to adjust dose; no blood level testing available; sometimes given twice a day.
It may take up to 3 weeks to get the right dose since one has to start at 25 mg. A dosetter (pill container with days marked) is a help.
Information on the web from the manufacturer AstraZeneca website: http://www.seroquel.com/
Clozapine – commercial name Clozaril-- made by Novartis – but now off patent Dose range: 150 - 600mg/day
J Most effective medication for treatment-resistant psychosis; good mood stabilizer;
probably decreases risk of aggression, suicide; can be given once a day; sedating; no
risk of muscle / movement side effects; blood level testing available. May improve verbal memory. Some people on clozapine seem to smoke and drink less.
L Rare risk of serious drop in white blood cell count – weekly blood monitoring for first 6
months of treatment, bi-weekly after that; high risk of weight gain; likely increased risk of glucose intolerance / diabetes; increased risk of seizures; nocturnal incontinence in some patients; increased nocturnal salivation; rare risk of heart disease. An annual check-up of heart function is recommended.
Information on the web from manufacturer Novartis website: http://www.clozaril.com/index.jsp Ziprasidone – commercial name: Geodon - made by Pfizer Dose range: 120-160 mg/day
J Medication available since 2002 in many countries. Best taken with food at the same
time each day. Is reported to be weight neutral. Because medications like ziprasidone sometimes affect heart rhythms, you should not take the medication if you have heart disease. It is wise to have a regular check up with a cardiologist recommended by your family physician.
Information on the web from the manufacturer Pfizer website: http://www.pfizer.com/download/uspi_geodon.pdf Aripiprazole – commercial name Abilify – made by Bristol-Myers, Squibb Dose range: 10 – 30 mg/day Please find information from the manufacturer on the Bristol-Myers’ website: www.abilify.com Early Intervention/ First Episode People being treated for a first episode of schizophrenia are usually put on a simple medication regimen. Psychiatrists advise that there is no benefit to taking two or more antipsychotic medications on a regular basis, though patients with schizophrenia are often prescribed anti- anxiety or anti-depressant tablets along with their anti-psychotic medication. We are now moving away from choosing the medication of least harm towards targeting the patient’s symptoms through the appropriate medication. Taking more than one antipsychotic or adjunctive medication Antipsychotic The medical profession does not generally recommend the use of more than one antipsychotic medication. If the person has been tried on two medications (first or second generation, i.e. old or new) one after the other with no beneficial effect, a trial of clozapine is often recommended. Trials of medications should last 4-6 weeks or even as long as 6 months with regular monitoring by the doctor. Adjunctive medication A person may be doing well on his antipsychotic medication but still have symptoms of depression, anxiety or obsessive compulsivity. In this case a doctor may prescribe medications intended for this purpose. In any event the person’s condition should be monitored regularly with regular visits to the doctor. Note on Dosage Information The Dose ranges given in the above pamphlet are those given in the U.S. PORT Update of Treatment Recommendations published in the Schizophrenia Bulletin Vol. 30 No.3. 2004. The information given above is to make people aware that new medications are available for the treatment of schizophrenia. It is not meant to be a comprehensive guide nor a recommendation for treatment with these compounds. Please talk to your physician/ psychiatrist about any concerns you have about your own treatment.
Baromètre santé médecins/pharmaciens 2003 254 l 18 l Methodology to prevention and health education? This chapter provides information on the invol-vement of professionals in preventive and Arnaud Gautier This chapter presents the method used for data collection, the specific features of the General Practitioners/Pharmacists Health 259 l 84 l Do immunization prac- Barometer 2