Рolypharmacy with antipsychotics in the treatment of schizophrenia in clinical practice Department of psychiatry and narcology

Abstract

Background. Despite the recommendations of the preferred use of antipsychotic monotherapy, use of antipsychotics in practice often differs from the developed algorithms. When a combination of antipsychotic drugs is used, prescribed doses often exceed recommended. Material and methods. We examined 38 patients with paranoid schizophrenia (47,4 % – female) undergoing treatment in three day hospital in St. Petersburg. “Brief assessment of cognitive functions in patients with schizophrenia” (BACS), “Complex figure of ReyCOsterrieth” as well as the Side Effect Rating Scale (UKU) and a selfCreport scale predictive of drug compliance (DAI) were used. Results and discussion. It was found that nearly 60 % of outpatient receive more than one antipsychotic and 73,7 % are treated with firstCgeneration antipsychotics. Polypharmacy was not the determining factor of the adherence to therapy and side effects. The average level of compliance reached 7,5 ± 1,5 points. It was found that more compliant patients have longer duration of disease (19,0 ± 9,0 vs. 10,8 ± 4,7 years, p = 0,008) and had undergone a greater number of hospitalizations (6,0 ± 3,7 vs. 3,0 ± 1,8, p = 0,017). They have better cognitive functioning (BACS total score 30,6 ± 13,7 vs. 18,8 ± 18,3 points, p = 0,071), particularly the level of planning and problemCsolving behavior (48,2 ± 24,3 vs. 25,6 ± 47,8 points, p = 0,11) and speech fluency (38,4 ± 10,4 vs. 31,2 ± 10,5 points, p = 0,066). Treatment exclusively with second generation antipsychotics positively correlated with duration of disease of patients (r = 0,422; p = 0,008) and was associated with higher scores for speech fluency (r = 0,329; p = 0,047).

Keywords

• schizophrenia
• antipsychotic therapy
• polypharmacy
• шизофрения
• антипсихотическая терапия
• полипрагмазия