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Antipsychotic polypharmacy and high-dose prescription in schizophrenia: a 5-year comparison

Authors
 Daeyoung Roh  ;  Jhin-Goo Chang  ;  Chan-Hyung Kim  ;  Hyun-Sang Cho  ;  Suk Kyoon An  ;  Young-Chul Jung 
Citation
 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, Vol.48(1) : 52-60, 2014 
Journal Title
 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY 
ISSN
 0004-8674 
Issue Date
2014
MeSH
Adult ; Antipsychotic Agents/administration & dosage ; Antipsychotic Agents/therapeutic use* ; Aripiprazole ; Dibenzothiazepines/administration & dosage ; Dibenzothiazepines/therapeutic use ; Female ; Humans ; Inpatients ; Male ; Middle Aged ; Piperazines/administration & dosage ; Piperazines/therapeutic use ; Polypharmacy* ; Practice Patterns, Physicians'/trends* ; Quetiapine Fumarate ; Quinolones/administration & dosage ; Quinolones/therapeutic use ; Republic of Korea ; Schizophrenia/drug therapy*
Keywords
Antipsychotics ; haloperidol ; high-dose antipsychotics ; polypharmacy ; quetiapine ; schizophrenia
Abstract
Objective: The co-prescription of multiple antipsychotic drugs continues to increase despite a lack of evidence supporting this practice. The purpose of this study was to quantify and describe recent trends of antipsychotic polypharmacy in Korean schizophrenic inpatients by comparing prescribed medications between the years of 2005 and 2010. Methods: We reviewed comprehensive medication profiles of schizophrenic patients discharged from a university psychiatric hospital in 2005 (n=194) or 2010 (n=201). Antipsychotic polypharmacy was defined as the concurrent receipt of two or more chemically distinct antipsychotics for at least 14 days. High antipsychotic dose was defined as a prescribed daily dose to defined daily dose ratio of greater than 1.5. Results: Antipsychotic polypharmacy increased between 2005 (37.1%) and 2010 (48.3%, p=0.025). The most frequently used drug within combinations of antipsychotics was haloperidol in 2005 (51.4%) and quetiapine in 2010 (48.5%). Overall, no changes were observed between 2005 and 2010 in the rate of prescribing high-dose antipsychotics. High-dose antipsychotic monotherapy decreased across years (from 30.4 to 18.4%), but high-dose antipsychotic polypharmacy increased (from 34.0 to 45.3%). Regression analysis revealed that antipsychotic polypharmacy was strongly associated with high doses of prescribed antipsychotics (odds ratio=18.60, p<0.001). Conclusions: The practice of prescribing multiple antipsychotics to patients with schizophrenia is increasing, and high-dose antipsychotic drugs are more likely to be prescribed in combination than in isolation. The reasons for this pattern of prescription and its impact warrants further study.
Full Text
http://anp.sagepub.com/content/48/1/52.long
DOI
10.1177/0004867413488221
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chan Hyung(김찬형)
Roh, Dae Young(노대영)
An, Suk Kyoon(안석균) ORCID logo https://orcid.org/0000-0003-4576-6184
Jung, Young Chul(정영철) ORCID logo https://orcid.org/0000-0002-0578-2510
Cho, Hyun Sang(조현상) ORCID logo https://orcid.org/0000-0003-1019-9941
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98047
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