Persistence with polypharmacy and excessive dosing in patients with schizophrenia treated in four European countries
| Autor: | Thomas Becker, Corrado Barbui, Maria Angela Mazzi, Graham Thornicroft, Stefan Weinmann, Maarten W. J. Koeter, Hedda Helm, Jonathan Bindman, Michele Tansella, Aart H. Schene, Michela Nosè, Morven Leese |
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| Přispěvatelé: | Amsterdam Neuroscience, Amsterdam Public Health, Adult Psychiatry |
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Psychosis Adolescent medicine.medical_treatment antipsychotic drugs dose regimens polypharmacy schizophrenia Time Persistence (computer science) Antipsychotic drugs Dose regimens Polypharmacy Schizophrenia Risk Factors Germany Internal medicine medicine Humans Pharmacology (medical) In patient Dosing Psychiatry Antipsychotic Aged Netherlands Psychiatric Status Rating Scales Dose-Response Relationship Drug business.industry Follow up studies Middle Aged medicine.disease United Kingdom Europe Psychiatry and Mental health Italy Socioeconomic Factors Female Schizophrenic Psychology business Antipsychotic Agents Follow-Up Studies |
| Zdroj: | International clinical psychopharmacology, 21(6), 355-362. Lippincott Williams and Wilkins |
| ISSN: | 0268-1315 |
| Popis: | The purpose of this study was to calculate the proportion of patients with schizophrenia receiving persistent antipsychotic polypharmacy and excessive dosing in four European countries; to test the hypothesis that excessive dosing and/or antipsychotic polypharmacy is associated with higher levels of psychopathology; and to establish whether use of second-generation antipsychotics is a protective or a risk factor for polypharmacy and excessive dosing. Participants with schizophrenia were recruited from patients under the care of psychiatric services serving geographical catchment areas in Croydon (UK), Verona (Italy), Amsterdam (Netherlands), and Leipzig (Germany). We defined patients persistently receiving high antipsychotic dose (i.e. excessive dosing) as those with a prescribed daily dose/defined daily dose ratio of >1.5 both at initial assessment and after 1 year of follow-up. Similarly, we defined patients persistently receiving polypharmacy as those being prescribed two or more antipsychotic drugs both at baseline and at follow-up. A sample of 375 participants with schizophrenia was analyzed. A proportion of 28% of patients persistently received high-dose antipsychotic drugs, and a proportion of 13% of patients persistently received antipsychotic polypharmacy. In the multivariate analysis, psychopathology was not a predictor of persistent polypharmacy and excessive dosing; similarly, use of second-generation antipsychotics was not associated with polypharmacy and excessive dosing; however, persistence with high antipsychotic doses was predicted by baseline use of first-generation antipsychotics and second-generation antipsychotics concurrently. Antipsychotic drug use for patients with schizophrenia is only sometimes satisfactory and offers the opportunity of improvement. Clinicians should consider that dose reduction strategies have been shown to be a feasible intervention in patients with schizophrenia |
| Databáze: | OpenAIRE |
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