Antipsychotic polypharmacy: Retrospective evaluation of cases with psychotic disorder followed in outpatient clinic (tur)

Şahabettin Çeti̇n, M. C. B. Şengül, Osman Özdel
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Abstract

Objective: In this study, it was aimed to investigate the sociodemographic and clinical features that may be related to antipsychotic polypharmacy and to discuss the causes and effects of this condition. Method: The records of the cases followed up at the psychotic disorders outpatient clinic were analyzed retrospectively. Sociodemographic and disease related clinical features, Clinical Global Impression Scale (CGI) Severity of Illness and Advers Events in their last applications were evaluated. Results: The most common diagnosis is schizophrenia with a rate of 63.6% (n = 150). It was determined that 76.7% (n = 181) of 236 patients included in the study were using at least two antipsychotic drugs, %64.8 (n=153) were using long acting parenteral antipsychotics. When comparing antipsychotic polypharmacy and monotherapy patients;statistically significant difference was found in terms of age, gender, onset age of disease, history of electroconvulsive therapy (ECT), long termparenteral antipsychotic use, number of hospitalizations and duration of their last hospitalization, Clinical Global Impression Scale severity of illness and advers events scores. Discussion: Although there is insufficient data on the efficacy and safety of antipsychotic polypharmacy, it appears that it is preferred in practice far above the recommendations of treatment guidelines.It seems important to understand the causes of this situation, and to make adjustments in the practices and guidelines of clinicians. Medical, social and economic consequences caused by antipsychotic polypharmacyshould be considered.
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综合抗精神病药物治疗:门诊精神病患者随访的回顾性评价
目的:本研究旨在探讨可能与多重服用抗精神病药物有关的社会人口学和临床特征,并探讨其原因和影响。方法:对精神障碍门诊随访病例进行回顾性分析。社会人口学和疾病相关的临床特征,临床总体印象量表(CGI)疾病严重程度和广告事件在他们的最后应用进行评估。结果:最常见的诊断为精神分裂症,发生率为63.6% (n = 150)。236例患者中,76.7% (n= 181)的患者至少使用两种抗精神病药物,64.8% (n=153)的患者使用长效非肠外抗精神病药物。在比较多药抗精神病药物和单药抗精神病药物患者时,在年龄、性别、发病年龄、电休克治疗(ECT)史、长期肠外抗精神病药物使用、住院次数和最后一次住院时间、临床总体印象量表疾病严重程度和不良事件评分方面存在统计学差异。讨论:尽管关于抗精神病药物综合用药的有效性和安全性的数据不足,但在实践中,它似乎比治疗指南的建议更受欢迎。了解这种情况的原因,并在临床医生的实践和指导方针中做出调整似乎很重要。应考虑抗精神病药物综合用药所造成的医疗、社会和经济后果。
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