'Real world' comparison of first- and second-generation antipsychotics in regard to length of inpatient hospitalization and number of re-hospitalizations.

The purpose of this study was to determine if Second-Generation Antipsychotics (SGAs), relative to First-Generation Antipsychotics (FGAs), reduced either the length of stay (LOS) or number of re-hospitalizations of schizophrenic patients receiving treatment in a state psychiatric hospital. Medical records were compared for the periods 1991-1994 and 2001-2004 for three inpatient groups: those receiving FGAs, those receiving SGAs, and those switched from FGAs to SGAs. During both time periods, patients on FGAs had significantly shorter LOS than either those receiving SGAs or those switched from FGAs to SGAs. Therefore, inpatients receiving SGAs were hospitalized longer than those receiving FGAs. Conversely, once discharged, patients receiving SGAs were significantly less likely to be re-admitted than patients discharged on FGAs. The data suggest that some patients do benefit from SGAs and it may be cost-effective in the long-term, to determine when to utilize FGAs first and when to switch from the older to the newer agents.