Arkin, Mental Health Care Institute Amsterdam, Amsterdam, the Netherlands.
Corresponding author: Dr M. Kikkert, PhD, Arkin, Klaprozenweg 111, 1033NN Amsterdam, the Netherlands (
J Clin Psychiatry. 2021 Dec 21;83(1):20m13756. doi: 10.4088/JCP.20m13756.
The aim of this study was to examine satisfaction with pharmacologic treatment in patients who received antipsychotic polypharmacy compared to antipsychotic monotherapy. This longitudinal cohort study was conducted in two mental health care institutes in Amsterdam, the Netherlands, among a randomly selected sample of in- and outpatients with a severe mental illness. Analyses were performed on data collected in 2011 for 185 patients who were diagnosed with schizophrenia or unspecified psychosis according to criteria. The outcome measure was the Treatment Satisfaction Questionnaire for Medication, version II. One-way analyses of covariance were performed to examine differences in treatment satisfaction between patients who received antipsychotic polypharmacy compared to antipsychotic monotherapy while controlling for the effects of clozapine, antipsychotic dose, and use of long-acting injectable antipsychotics. Twenty percent of patients in this sample received 2 antipsychotic agents; in half of those patients, this involved a combination with clozapine. Polypharmacy resulted in less satisfaction with side effects compared to monotherapy ( = .002). No difference was found in perceived effectiveness ( = .168) or overall medication satisfaction ( = .379). These results confirm that antipsychotic polypharmacy is common in a random in- and outpatient sample. Patients who receive 2 antipsychotic agents are just as positive about the effectiveness and ease of use of and overall satisfaction with their medication compared to those who receive antipsychotic monotherapy. They are, however, less satisfied with perceived side effects of their medication, which may indicate that side effect profiles of antipsychotic combinations are less favorable.
本研究旨在考察接受抗精神病药联合治疗的患者与接受单药治疗的患者在药物治疗满意度方面的差异。这项纵向队列研究在荷兰阿姆斯特丹的两家精神卫生保健机构中进行，对象为符合入选标准的门诊和住院的严重精神疾病患者，采用随机抽样方法。对 2011 年收集的 185 名患者的数据进行了分析，这些患者根据诊断标准被诊断为精神分裂症或未特指的精神病。评估指标为药物治疗满意度问卷（Treatment Satisfaction Questionnaire for Medication，version II）。采用单因素协方差分析（one-way analyses of covariance），在控制氯氮平、抗精神病药剂量和使用长效注射用抗精神病药的影响后，比较接受抗精神病药联合治疗和单药治疗的患者在治疗满意度方面的差异。该样本中有 20%的患者接受了 2 种抗精神病药物治疗；其中一半患者的联合用药中包含氯氮平。与单药治疗相比，联合治疗的副作用满意度较低（ = .002）。在疗效感知（ = .168）和总体药物满意度（ = .379）方面，两组间无差异。这些结果证实，在随机门诊和住院患者样本中，抗精神病药联合治疗非常常见。与接受单药治疗的患者相比，接受两种抗精神病药物的患者对药物的疗效、易用性和总体满意度同样持积极态度。然而，他们对药物副作用的感知满意度较低，这可能表明抗精神病药联合治疗的副作用特征不太理想。
