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Objective: The aim of this study was to examine the characteristics of treatment of early-onset schizophrenia patients that were treated in child and adolescent psychiatry inpatient clinic of Bakirkoy Mental Hospital.
Method: The psychiatric records of 40 patients with early-onset schizophrenia, who were hospitalized in the child and adolescent psychiatry inpatient clinic of Bakirkoy Mental Hospital were assessed by retrospective chart review.
Results: Twelve of the patients were female and 28 were male. The ages of the patients were between 11 and 18 years, with a mean of 15.75 years. The most commonly used antipsychotics for the treatment of patients were: risperidone (n=28), quetiapine (n=19), aripiprazole (n=19), olanzapine (n=18), clozapine (n=7), haloperidol (n=7), amisulpiride (n=6) and ziprasidone (n=4). The dosage of risperidone ranged between 2 and 8 mg/day, with a mean dose of 5.54 mg/day. The dosage of olanzapine ranged between 10 and 30 mg/day, with a mean dose of 19.41 mg/day. The dosage of quetiapine ranged between 400 and 1200 mg/day, with a mean dose of 705.26 mg/day. The dosage of aripiprazole ranged between 10 and 30 mg/day, with a mean dose of 20 mg/day. The dosage of clozapine ranged between 200 and 900 mg/day, with a mean dose of 541.66 mg/day. The dosage of haloperidole ranged between 15 and 20 mg/day, with a mean dose of 19.28 mg/day. The dosage of amisulpiride ranged between 200 and 1000 mg/day, with a mean dose of 633.33 mg/day. The dosage of ziprasidone ranged between 80 and 160 mg/day, with a mean dose of 140 mg/day. While 27 patients responded to monotherapy with risperidone (n=8), aripiprazole (n=5), olanzapine (n=4), clozapine (n=3), quetiapine (n=3) and other drugs (n=4); 5 of the patients responded to combination treatments (risperidone & aripiprazole, clozapine & quetiapine, ziprasidone & quetiapine, aripiprazole & quetiapine, risperidone & quetiapine). Five of the patients did not respond to any medications. Response to medication was unclear for 3 patients. Side effects were seen in 5 patients with risperidone (increase in the frequency of epileptic seizures, tardive dyskinesia, enuresis, akathizia and extrapyramidal symptoms), 2 patients with clozapine (neutropenia and hypersalivation), 3 patients with quetiapine (enuresis, hypotension, weight gain), 3 patients with olanzapine (myopia due to accommodation, increase in the frequency of epileptic seizures), 3 patients with aripiprazole (increase in the frequency of epileptic seizures, akathizia, facial spasm and extrapyramidal symptoms).
Conclusions: Early-onset schizophrenia is a devastating disorder that needs to be treated with antipsychotics. Children and adolescents with schizophrenia may need high doses of antipsychotics. Although some patients may benefit from monotherapy, some of the patients may benefit from combination treatment. Also, side effects should be closely monitored.