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You are asked to develop a decision tree for the state department of mental health to represent the decision between risperidone and the use of

You are asked to develop a decision tree for the state department of mental health to represent the decision between risperidone and the use of conventional psychotropic agents in the treatment of schizophrenia. Your review of risperidone usage by state mental health physicians indicates that risperidone is used at either 2mg, 6mg, 10mg, or 16mg. The most frequently used traditional psychotropic agent is haloperidol at 20 mg per day. Patients treated with these agents either respond within the first month or do not respond and are considered refractory and placed on clozapine. (Assume that the patients are started at one of the four doses with no changes).

A review of the literature reveals the following probabilities of treatment success for the respective agents:

Drug and Dose

Probability of Success

Risperidone 2 mg

.40

Risperidone 6 mg

.60

Risperidone 10 mg

.30

Risperidone 16 mg

.50

Haloperidol 20 mg

.25

Of those patients that are considered a treatment success, a certain percentage will develop extrapyramidal side effects, which require treatment with additional pharmaceuticals. The probabilities for developing EPS with these agents are:

Drug and Dose

Probability of EPS

Risperidone 2 mg

.10

Risperidone 6 mg

.20

Risperidone 10 mg

.35

Risperidone 16 mg

.15

Haloperidol 20 mg

.30

Develop and label the decision tree.

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