Polypharmacy in the antipsychotic prescribing in practices psychiatric out-patient clinic

Abstract

Introduction. Due to the lack of scientific studies in the psychopharmacological treatment of psychosis, the references advise against the use of antipsychotic polypharmacy (AP). This study investigates the situation of this matter and its relationship with the introduction of atypical antipsychotics (AA) in our daily out-patient practice.

Methods. The study group included 160 patients, with ICD-10 diagnosis of non-affective psychosis and illness evolution of at least two years, whose ages ranged from 18 to 65 years, without mental retardation, who came to the out–patient clinic at least once during the first semester of 2002 and, in order to make a comparison, at least one other time 9 to 12 months before. The retrospective study was done using the clinical records.

Results. In both moments studied, more than 50 % of the patients (65 % and 63.4 % respectively) had AA as their only treatment. AP was 25.6 % and 26.9 % respectively, 19.4 % of all patients were always in AP. At the end of the study, patients on AP were being prescribed a higher dose of chlorpromazine equivalents per day (p <0.001) and more anticholinergics (p <0.001).

Conclusions. Our results show that in out–patient settings AA have been consolidated as the first treatment option and that AP is a very common and stable phenomenon.