Rethinking antipsychotic formulary policy

R. A. Rosenheck, D. L. Leslie, Susan Busch, Ethan S. Rofman, Michael Sernyak

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

In this commentary, we review recent research suggesting that (a) second-generation antipsychotics (SGAs) may be no more effective than first-generation antipsychotics (FGAs), (b) the reduced risk of EPS and tardive dyskinesia with SGAs is more weakly supported by the research literature than has been appreciated, and (c) benefits may be offset by greater metabolic risks of some SGAs and their substantially greater cost. Bearing in mind, as well, that risperidone, currently the least expensive SGA, will soon be available as an even less expensive generic drug, we propose a new algorithm for maintenance antipsychotic therapy. We further outline a cautious implementation procedure that relies on standardized documentation and feedback, without a restrictive formulary that would limit physician choice. The algorithm outlined here and the process for its implementation are intended as a stimulus for discussion of potential policy responses, not as a finalized proposition.

Original languageEnglish (US)
Pages (from-to)375-380
Number of pages6
JournalSchizophrenia Bulletin
Volume34
Issue number2
DOIs
StatePublished - Mar 1 2008

Fingerprint

Formularies
Antipsychotic Agents
Generic Drugs
Risperidone
Research
Documentation
Maintenance
Physicians
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

Rosenheck, R. A., Leslie, D. L., Busch, S., Rofman, E. S., & Sernyak, M. (2008). Rethinking antipsychotic formulary policy. Schizophrenia Bulletin, 34(2), 375-380. https://doi.org/10.1093/schbul/sbm089
Rosenheck, R. A. ; Leslie, D. L. ; Busch, Susan ; Rofman, Ethan S. ; Sernyak, Michael. / Rethinking antipsychotic formulary policy. In: Schizophrenia Bulletin. 2008 ; Vol. 34, No. 2. pp. 375-380.
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Rosenheck, RA, Leslie, DL, Busch, S, Rofman, ES & Sernyak, M 2008, 'Rethinking antipsychotic formulary policy', Schizophrenia Bulletin, vol. 34, no. 2, pp. 375-380. https://doi.org/10.1093/schbul/sbm089

Rethinking antipsychotic formulary policy. / Rosenheck, R. A.; Leslie, D. L.; Busch, Susan; Rofman, Ethan S.; Sernyak, Michael.

In: Schizophrenia Bulletin, Vol. 34, No. 2, 01.03.2008, p. 375-380.

Research output: Contribution to journalArticle

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Rosenheck RA, Leslie DL, Busch S, Rofman ES, Sernyak M. Rethinking antipsychotic formulary policy. Schizophrenia Bulletin. 2008 Mar 1;34(2):375-380. https://doi.org/10.1093/schbul/sbm089