Trends in the pharmacological treatment of patients with schizophrenia over a 12 year observation period

The impact of a change in prescribing policy on antipsychotic prescribing in a general adult psychiatric hospital

“…The latter figure provided by Dr Kelly and his colleagues (i.e. 16%) is comparable with the 14.4% figure found in a survey of prescribing multiple antipsychotics for patients with schizophrenia in the United States (Edlinger et al 2005) and the 15.9% figure reported in a similar English survey (Patel et al 2014). A recent French study reported a staggering 49.3% rate of prescribing for multiple antipsychotics across all general hospitals in France (Bret et al 2009).…”

Pattern of psychotropic prescription in a tertiary care center: A critical analysis

“…[13] Although, irrational polypharmacy occurs too frequently but in many instances it is necessary to manage the patient with multiple medications and that makes rational polypharmacy. [1714] The classic example is the use of benztropine to manage side effects from haloperidol. Another example is the use of lithium to augment a partial response to an antidepressant and thus, increase its efficacy.…”

“…[12] According to Preskorn and Lacey clinicians there are several reasons for polypharmacy: to treat two pathophysiologically distinct but co morbid illnesses in the same patient; to prevent an adverse effect produced by the primary drug; to provide acute amelioration while awaiting the delayed effect of another medication (e.g., using lorazepam in acute mania while waiting for the antimanic effects of lithium to exert themselves); to treat intervening phases of an illness (e.g., adding an antidepressant to a mood stabilizer when a bipolar patient develops a depressive episode); and to boost or augment the efficacy of the primary treatment (e.g., combining a selective serotonin reuptake inhibitor and desipramine to treat a patient with major depression). [3]…”

The impact of a change in prescribing policy on antipsychotic prescribing in a general adult psychiatric hospital

“…A meta-analysis of 14 studies investigating clozapine augmentation with a second antipsychotic demonstrated a small reduction in symptom scores compared with augmentation with a placebo , though there is little evidence to demonstrate that, excluding co-prescribing with clozapine, multiple antipsychotic prescribing is an effective treatment strategy (Kane et al 2009). Despite this, multiple antipsychotic prescribing occurs in up to 15-20% of patients with schizophrenia (Edlinger et al 2005;Patel et al 2014).…”