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Skating on thin ice: pragmatic prescribing for medication refractory schizophrenia

Overview of attention for article published in BMC Psychiatry, July 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • High Attention Score compared to outputs of the same age and source (90th percentile)

Mentioned by

news
1 news outlet
blogs
1 blog
twitter
3 X users
facebook
1 Facebook page
reddit
1 Redditor

Citations

dimensions_citation
14 Dimensions

Readers on

mendeley
64 Mendeley
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Title
Skating on thin ice: pragmatic prescribing for medication refractory schizophrenia
Published in
BMC Psychiatry, July 2015
DOI 10.1186/s12888-015-0559-x
Pubmed ID
Authors

Derek K. Tracy, Dan W. Joyce, S. Neil Sarkar, Maria-Jesus Mateos Fernandez, Sukhwinder S. Shergill

Abstract

Clozapine is the treatment of choice for medication refractory psychosis, but it does not benefit half of those put on it. There are numerous studies of potential post-clozapine strategies, but little data to guide the order of such treatment in this common clinical challenge. We describe a naturalistic observational study in 153 patients treated by a specialist psychosis service to identify optimal pharmacotherapy practice, based on outcomes. Medication and clinical data, based on the OPCRIT tool, were examined on admission and discharge from the national psychosis service. The primary outcome measure was the percentage change in mental state examination symptoms between admission and discharge and the association with medication on discharge. Exploratory analyses evaluated the specificity of individual medication effects on symptom clusters. There were fewer drugs prescribed at discharge relative to admission, suggesting an optimisation of medication, and a doubling of the number of patients treated with clozapine. Treatment with clozapine on discharge was associated with maximal decrease in symptoms from admission. In the group of patients that did not respond to clozapine monotherapy, the most effective drug combinations were clozapine augmentation with 1) sodium valproate, 2) lithium, 3) amisulpride, and 4) quetiapine. There was no support for a dose-response relationship for any drug combination. Clozapine monotherapy is clearly the optimal medication in medication refractory schizophrenia and it is possible to maximise its use. In patients unresponsive to clozapine monotherapy, augmentation with sodium valproate, lithium, amisulpride and quetiapine, in that order, is a reasonable treatment algorithm. Reducing the number of ineffective drugs is possible without a detrimental effect on symptoms. Exploratory data indicated that clozapine was beneficial across a range of symptoms domains, whereas olanzapine was beneficial specifically for hallucinations and lamotrigine for comorbid affective symptoms.

X Demographics

X Demographics

The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Chile 1 2%
Canada 1 2%
Unknown 62 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 19%
Researcher 9 14%
Student > Ph. D. Student 8 13%
Student > Bachelor 6 9%
Other 5 8%
Other 12 19%
Unknown 12 19%
Readers by discipline Count As %
Medicine and Dentistry 20 31%
Psychology 8 13%
Pharmacology, Toxicology and Pharmaceutical Science 5 8%
Agricultural and Biological Sciences 3 5%
Biochemistry, Genetics and Molecular Biology 3 5%
Other 10 16%
Unknown 15 23%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 May 2019.
All research outputs
#2,064,415
of 23,881,329 outputs
Outputs from BMC Psychiatry
#732
of 4,939 outputs
Outputs of similar age
#27,233
of 265,689 outputs
Outputs of similar age from BMC Psychiatry
#9
of 81 outputs
Altmetric has tracked 23,881,329 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,939 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.9. This one has done well, scoring higher than 85% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,689 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 81 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.