Background
Analysis of the prescribing patterns of antipsychotic drugs can improve therapeutic
outcomes. The purpose of this study was to evaluate the prescribing pattern of
antipsychotics and its conformance to international treatment guidelines.
Methods
A cross sectional study at primary psychiatric centers was carried out.
Patients’ medical files were used to obtain demographic, medication and
clinical information. International guidelines for schizophrenia were used to
create conformance indicators. All statistical analyses were conducted using
Statistical Package for Social Sciences.
Results
250 patients were included in this study. A total of 406 antipsychotic agents
were used; 348 (85.7%) were first generation antipsychotics (FGA). The
prevalence of antipsychotic combination was 50.4% (n=126). There was no
significant difference in positive (p=0.3), negative (p=0.06) and
psychopathology (p=0.5) scores of schizophrenia symptoms among patients on
monotherapy versus those on antipsychotic combination. Furthermore, no
significant difference was observed in the annual cost of antipsychotic monotherapy
versus combination therapy. One hundred and five patients (42%) were using
optimum dose of (300 – 600 mg CPZeq) while the remaining were using sub or
supra therapeutic doses. Analysis showed that use of depot, use of
anticholinergic agents and increasing amount of total CPZeq were significant
factors associated with antipsychotic combination.
Conclusions
This study indicated that antipsychotic prescribing was not in conformance with
international guidelines with respect to maintenance dose and combination
therapy. Type of antipsychotic treatment regimen, combination versus
monotherapy, was not associated with better clinical or economic outcome.
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