Antipsychotic drug use pattern for patients with schizophrenia in an outpatient clinic in Turkey: A retrospective study.

INTRODUCTION

Pharmacotherapy for schizophrenia is a dynamic process that can change over time. The goal of this study was to examine the pattern of antipsychotic drug (APD) use for patients with schizophrenia in an outpatient clinic.

METHOD

We evaluated the medication use pattern in patients with schizophrenia treated with antipsychotic drugs in an outpatient clinic in a period of 4 years. Patients who used any antipsychotic medication stably for at least 6 months were included in the study in this period. Patients who had been noncompliant to the treatment or did not come to the clinic again were excluded. Patients' records were reviewed in respect to the use of APD as an initial treatment, the duration of a single or combined APD use, the changing of APD regimen, and adding of a new APD or other adjuvant drugs to APDs.

RESULTS

A total of 152 patients diagnosed with schizophrenia were treated during the study period, of whom 60 (39.5%) maintained the treatment with compliance for at least 6 months. Mean duration of the treatment was 15.8 (+10.7) months (range 6-48). The most commonly used antipsychotic drugs were atypical agents (in 68.3% of patients), and depot neuroleptics were used in the 46.7% of patients more often than any other antipsychotic drug at any time of the treatment. Two or more antipsychotic drugs were used at some time during this period in 24 patients (40.0%). Of all patients, 45.0% had their drug regimen changed: medication regimen was changed once in 28.3% patients and two to four times in 16.7% patients. The longer the duration of treatment, the more patients had their medication changed. Most added drugs were typical ones (16.7%). Of all patients, 48 (80.0%) had used adjuvant drugs at any time during the treatment. There were no differences between the use of combined drug, medication changing and demographic variables of the patients.

CONCLUSION

The results of this study support previous reports of the frequent use of atypical antipsychotic drugs, combination antipsychotic therapy, and adjuvant drugs in clinical practice. Medication switching is more common in the treatment of patients with schizophrenia. Prospective controlled trials are needed to determine whether combination antipsychotic therapy or switching medication regimen is clinically beneficial and to provide guidelines on when and for whom that should be considered. (Int J Psych Clin Pract 2004; 8: 41-45).