Clinical Correlates and Description Profiles of Antipsychotic Polypharmacy for Patients with Schizophrenia

Jinyoung Choi; Shi Hyun Kang; Jong-Il Lee; Yujeong Ha; Hai Joo Yoon; Eunkyung Park; Dong Yeon Park

doi:10.4306/jknpa.2014.53.6.370

Journal List > J Korean Neuropsychiatr Assoc > v.53(6) > 1017701

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Choi, Kang, Lee, Ha, Yoon, Park, and Park: Clinical Correlates and Description Profiles of Antipsychotic Polypharmacy for Patients with Schizophrenia

Original Article

Journal of Korean Neuropsychiatric Association 2014; 53(6): 370-378.

Published online: 30 November 2014

DOI: https://doi.org/10.4306/jknpa.2014.53.6.370

Clinical Correlates and Description Profiles of Antipsychotic Polypharmacy for Patients with Schizophrenia

Jinyoung Choi, MD¹, Shi Hyun Kang, MD, PhD¹, Jong-Il Lee, MD, PhD¹, Yujeong Ha, MPH², Hai Joo Yoon, MA³, Eunkyung Park, RN⁴, Dong Yeon Park, MD, PhD¹

¹Department of Psychiatry, Seoul National Hospital, Seoul, Korea.

²Department of Mental Health Research, Seoul National Hospital, Seoul, Korea.

³Department of Clinical Psychology, Seoul National Hospital, Seoul, Korea.

⁴Clinical Trial Center, Seoul National Hospital, Seoul, Korea.

Address for correspondence: Dong Yeon Park, MD, PhD. Department of Psychiatry, Seoul National Hospital, 398 Neungdong-ro, Gwangjin-gu, Seoul 143-711, Korea. Tel +82-2-2204-0377, Fax +82-2-2204-0394, hyperma@korea.kr

Received 28 July 2014 Revised 24 August 2014 Accepted 23 September 2014

Abstract

Objectives

Despite increasing use of antipsychotic polypharmacy (APP), few studies have investigated APP for Korean patients with schizophrenia. The aim of this study was to identify the sociodemographic and clinical correlates and recent prescription profiles of APP in schizophrenia patients.

Methods

A total of 297 schizophrenia patients were recruited and interviewed using standardized assessment instruments in Seoul National Hospital. Differences in demographic and clinical characteristics between APP and antipsychotic monopharmacy (APM) groups were analyzed. The prescriptions of psychotropic drugs were collected by a review of medical records.

Results

In comparison with the APM group, the APP group showed association with earlier onset, lower employment rate, and higher scores for Clinical Global Impression-Severity and Brief Psychiatric Rating Scale (BPRS) (p<0.001). In particular, the BPRS positive (p<0.001) and affective symptom scores (p<0.001) of the APP group were higher those of the APM group. The most frequent combination pattern of APP was second generation antipsychotics (SGA)+SGA, followed by SGA+first generation antipsychotics (FGA), and SGA+SGA+FGA. For antipsychotics, it was risperidone+quetiapine, followed by clozapine+risperidone, risperidone+sulpiride, and risperidone+haloperidol.

Conclusion

The current study suggests that the usage of APP for schizophrenia could be related to symptom severity affected by positive and affective symptoms. The prescription profile reflects that the proportion of atypical antipsychotics on APP has increased.

Keywords: Antipsychotic polypharmacy (APP), Schizophrenia, Clinical correlates, Brief Psychiatric Rating Scale (BPRS), Prescription profiles

Figures and Tables

Table 1

Comparisons of sociodemographic characteristics between APM and APP group

APM : Antipsychotic monopharmacy, APP : Antipsychotic polypharmacy

Table 2

Comparisons of clinical characteristics between APM and APP group

AIMS : Abnormal Involuntary Movement Scale, APM : Antipsychotic monopharmacy, APP : Antipsychotic polypharmacy, SAS : Simpson-Angus Scale, CGI-S : Clinical Global Impression-Severity, MSQ : Medication Satisfaction Questionnaire

Table 3

Comparisons of BPRS score between APM and APP group

APM : Antipsychotic monopharmacy, APP : Antipsychotic polypharmacy, BPRS : Brief Psychiatric Rating Scale, SD : Standard deviation

Table 4

Combination patterns of antipsychotics for patients with antipsychotics polypharmacy

FGA : First-generation antipsychotic, SGA : Second-generation antipsychotic

Table 5

Prescription of antipsychotics for patients with antipsychotics polypharmacy [mean dose (mg)±standard deviation]

Notes

The authors have no financial conflicts of interest.

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