How Long do Psychiatrists Wait for Response Before They Switch to Another Antipsychotic?

For how long an antipsychotic should be tried before it is considered ineffective is an important but as yet unanswered question. For the individual patient, it is of great relevance whether to be maintained on an ineffective drug for 2, 4, 6, or 8 weeks. Interviews with two samples of German hospital psychiatrists were undertaken to study treatment patterns with respect to antipsychotic nonresponse. Psychiatrists waited for an average of 3 weeks before switching antipsychotics due to nonresponse. However, there was considerable practice variation between individual physicians and hospitals. In practice, this might result in different lengths of drug trials for individual patients depending on the admitting hospital. Evidence-based guidance for psychiatrists is needed to avoid too early switches or too long drug trials. Psychopharmacology Bulletin. 2007;40(3):149-154.