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Year : 2020  |  Volume : 27  |  Issue : 1  |  Page : 30-36

Antipsychotic prescription and polypharmacy among outpatients with schizophrenia in a Nigerian hospital

Department of Clinical Services, Federal Neuropsychiatric Hospital, Benin-City, Nigeria

Correspondence Address:
Dr. Ihechiluru Goodnews Anozie
Department of Clinical Services, Federal Neuropsychiatric Hospital, P.M.B 1108, Benin-City
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/npmj.npmj_93_19

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Background: International guidelines recommend antipsychotic monotherapy as the ideal treatment option in pharmacotherapy for schizophrenia, though this yields modest outcomes in a third of patients. Antipsychotic polypharmacy (APP) has been tried in many patients with schizophrenia to improve outcomes in those with poor treatment response. Objectives: This study examined the pattern of antipsychotic prescription and polypharmacy among outpatient attendees with schizophrenia in a Nigerian psychiatric hospital. Methods: A cross-sectional study of 320 attendees with schizophrenia at the consultant outpatient department was undertaken. We administered a socio-demographic questionnaire, antipsychotic medication and health questionnaire to record the general health indices and the prescribed antipsychotic medication of participants and the Mini-International Neuropsychiatric Interview (MINI) Version 6.0 (psychosis module). Results: Oral second-generation antipsychotics (SGAs) monotherapy was most commonly prescribed. The prevalence of APP was 50.9%. Participants on simultaneous anticholinergic agents (P < 0.001), a twice-daily antipsychotic dosing interval (P < 0.001,) alcohol use (P = 0.02), antidepressant use (P = 0.02) and a current episode of schizophrenia on the MINI (P < 0.001) were more likely to be on an APP regimen. Conclusion: Although a preference for SGA monotherapy was observed, the prevalence of APP remained high. Clinicians, therefore, should be cautious regarding the clinical utility of APP and discourage its persistent use.

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