Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-16T09:33:04.158Z Has data issue: false hasContentIssue false
  • English
  • Français

Combined antipsychotic use in a community rehabilitation psychiatric service

Published online by Cambridge University Press:  13 June 2014

Tunde Apantaku-Olajide ,
Abid Khattak  and
Peter Whitty
Tunde Apantaku-Olajide*
Affiliation:
Dublin University Psychiatry Rotational Training Programme, Dublin
Abid Khattak
Affiliation:
Psychiatric Rehabilitation and Recovery Unit, St. Loman's Hospital, Dublin
Peter Whitty
Affiliation:
Department of Psychiatry, Adelaide & Meath Hospital, Tallaght, Dublin 24, Ireland
*
*Correspondence E-mail: tunyapans@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Despite the clinical guidelines regarding the use of combined antipsychotics and the limited evidence for its benefits, use remains high in psychiatric practice. The aim of this study was to examine prescribing practices and investigate reasons for initiating and continuing combined antipsychotics in stable psychiatric illnesses.

Method:

A cross-sectional case record survey of antipsychotic prescribing practices in a community psychiatric rehabilitation service. A total sample (n = 75) of patients with chronic and enduring psychiatric illnesses was studied. The age, gender, diagnosis and prescribed antipsychotics were examined. The proportional prevalence and documented reasons for combined antipsychotic prescribing were analysed.

Results:

Seventy-three of the 75 patients were prescribed antipsychotic mediations. Of these, 44 (60%) received a combination of two or more antipsychotics. The most common reason for combined prescribing was a switch of antipsychotic (n = 18; 41%). No reason was documented in 19 cases (43%).

Conclusions:

In this study, slow cross-tapering or incomplete switch process of antipsychotics contributed to the prolonged period of combined antipsychotics treatment. Adequate documentation regarding indication and review of medications cannot be overemphasized.

Keywords

Combined antipsychoticsPsychiatricCommunity rehabilitation
Type
Brief Report
Information
Irish Journal of Psychological Medicine , Volume 27 , Issue 3 , September 2010 , pp. 138 - 140
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Patrick, V, Schleifer, SJ, Nurenberg, JR, Gill, KJ.Best practices: An initiative to curtail the use of antipsychotic polypharmacy in a state psychiatric hospital. Psychiat Serv 2006, 57: 21–23.CrossRefGoogle Scholar
2. Schizophrenia Ireland. Quality of Choice: Survey of Service Users Experience of Mental Healthcare Treatment. Dublin: SI, 2002.Google Scholar
3.Sim, K, Su, A, Fuji, Set al.Antipsychotic polypharmacy in patients with schizophrenia: a multicentre comparative study in East Asia. Br J Clin Pharmacol 2004; 58: 178–183.CrossRefGoogle ScholarPubMed
4.Sernyak, MJ, Rosenheck, R.Clinicians' reasons for antipsychotics co prescribing. J Clin Psychiat 2004; 65: 1597–1600.CrossRefGoogle Scholar
5.Miller, AL, Craig, CS.Combination antipsychotics: pros, cons, and questions. Schiz Bull 2002; 28: 105–109.CrossRefGoogle ScholarPubMed
6.Loosbrock, DL, Zhao, Z.Antipsychotic medication use patterns and associated costs of care for individuals with schizophrenia. J Ment Health Pol Econ 2003; 6: 67–75.Google ScholarPubMed
7.Jaffe, AB, Levine, J.Antipsychotic medication co-prescribing in a large state hospital system. Pharmacoepidemiol Drug Saf 2003; 12: 41–48.CrossRefGoogle Scholar
8.Faries, D, Ascher-Svanum, H, Zhu, B, Correll, C, Kane, J.Antipsychotic monotherapy and polypharmacy in the naturalistic treatment of schizophrenia with atypical antipsychotics. BMC Psychiatry 2005 May 27; 5: 26CrossRefGoogle ScholarPubMed
9.Schumacher, JE, Makela, EH, Griffin, HR.Multiple antipsychotic medication prescribing patterns. Ann Pharmacother 2003, 37: 951–955.CrossRefGoogle ScholarPubMed
10.Kissling, W, Seemann, U, Piwemetz, K.Quality management in psychiatry. Int Clin Psychopharmacol 2001; 16(Suppl 3); S15–S24.CrossRefGoogle ScholarPubMed
11.The expert consensus guideline series. Treatment of schizophrenia. J Clin Psychiat 1999:3–80.Google Scholar
12.Weiden, PJ: Switching antipsychotics: an up-dated review with a focus on quetiapine. J Psychopharmacol 2006; 20: 104CrossRefGoogle Scholar
13.De Nayer, A, Windhager, E, Irmansyah, et al.Efficacy and tolerability of quetiapine in patients with schizophrenia switched from other antipsychotics. Int J Psychiatry Clin Pract 2003, 7: 59–66.CrossRefGoogle ScholarPubMed
14.Gillain, B, Van Peborgh, P, De Brueeker, G, Peuskens, J.Quetiapine clinical use in real-life environment - the SECURE Study. Eur Neuropsychopharmacol 2002; 12 (Suppl. 3):S263, abs P.2.021.CrossRefGoogle Scholar
15.McGrath, BM, Tempier, RP.Implementing Quality Management in Psychiatry: From Theory to Practice — Shifting focus from Process to Outcome. Can J Psychiat 2003; 48: 467–474.CrossRefGoogle ScholarPubMed