Antipsychotic Polypharmacy in Schizophrenic Inpatients

Objective: Since new anti-psychotics have been developed in recent years and their use became increasingly common, clinicians prefer treatment with antipsychotic polypharmacy. The aim of this survey is to determine the prevalence of antipsychotic polypharmacy in patients with schizophrenia at the inpatient unit in Bakirkoy Mental Health and Neurological Diseases Training and Research Hospital and to investigate the relationship between antipsychotic polypharmacy, and sociodemographic factors and patient characteristics. Methods: We evaluated the medical records of 272 patients who were diagnosed with schizophrenia without comorbid psychiatric disorders at the inpatient clinic, Bakirkoy Mental Health and Neurological Diseases Training and Research Hospital, in 2003 and their records of one-year follow-up period after discharge, retrospectively. Data on sociodemographic features and pharmacological treatments collected from the inpatient records were evaluated. Results: The prevalence rate of antipsychotic polypharmacy use in the treatment of patients with schizophrenia was found to be 48.89%. The most frequently prescribed combination was the first generation+ first generation antipsychotics (64.66%). The number of the patients rehospitalized within one year was higher in those who had been treated with antipsychotic polypharmacy (p<0.05). The patients treated with antipsychotic polypharmacy were with earlier age at onset of the disease compared to patients with monotherapy (p<0.05). The patients treated with antipsychotic polypharmacy had longer duration of illness than the patients with monotherapy (p<0.05). The patients treated with antipsychotic polypharmacy had shorter duration of hospital stay than patients with monotherapy (p<0.05). Conclusion: We found the frequency of antipsychotic polypharmacy in inpatients with schizophrenia to be 48.89%, which is similar to the literature. The antipsychotic polypharmacy was observed to be associated with earlier age at illness onset, longer duration of illness and shorter duration of hospital stay. (Archives of Neuropsychiatry 2010; 47: 23-8)