Assessment of Antipsychotic Combination Therapy among Patients with Schizophrenia on Follow-up at Amanuel Specialized Mental Hospital
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Date
2016-03
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Addis Ababa University
Abstract
Antipsychotic medications are first line for the treatment of patients with schizophrenia. Although monotherapy is supported, antipsychotic combination therapy in schizophrenia is common in clinical practices. However, there are issues with this treatment approach regarding safety, nonadherence, increment in daily dose and cost. This study aimed to assess the practice of antipsychotic combination therapy among patients with schizophrenia on follow-up. Cross-sectional study was conducted from August 10 to September 10, 2015 at Amanuel Specialized Mental Hospital. Data was collected through a two stage process. First, patients were interviewed using a pretested structured questionnaire. In the second stage, information on diagnosis and treatment was extracted from the medical records of patients who were interviewed face to face. A total of 423 patients participated in the study. The prevalence of antipsychotic combination therapy was 21.8%. The drug most frequently involved in combination therapy was fluphenazine decanoate depot while the frequently drug combination type was chlorpromazine orally with fluphenazine decanoate depot. The most common reason for combination was inadequate response (52.8%) to treatment. Younger age (25-34 years), male sex, greater than ten years duration of illness, frequent hospital admissions, severe side effect burdens and anticholinergic use had positive association with antipsychotic combination therapy. On the other hand, age group of 35-44 years had an inverse relation with antipsychotic combination therapy. From this study, antipsychotic combination therapy was practiced on a fifth of the study participants. As a result, development of treatment guideline and broadening the availability of other second generation antipsychotics should be warranted.
Key Words: Antipsychotic medications, Combination therapy, Schizophrenia, Follow-up
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Antipsychotic medications; Combination therapy; Schizophrenia, Follow-up