The prescription patterns of second-generation antipsychotics in schizophrenia outpatient setting

Abstract

Background Schizophrenia is a chronic disorder that requires long-term treatment to achieve symptom remission and quality of life improvement. Antipsychotic medications are primary treatments for schizophrenia patients. Second-generation antipsychotics (SGAs) have been recognized as first-line drugs in the treatment of schizophrenia. This study aimed at determining the prescription patterns of SGAs in schizophrenia outpatients in the National Mental Hospital in Indonesia. Methods A retrospective study with descriptive analysis was conducted between October and December 2018, exclusive to data of the patients with schizophrenia only. Data were collected from the prescription records of schizophrenia outpatients. This study performed a descriptive analysis of patient characteristics, percentage of SGAs prescribed, regimen doses of SGAs, average number of SGAs prescribed per patient, and pattern of antipsychotics prescribed. Results The most commonly used SGAs were risperidone 55%, followed by clozapine 38%, aripiprazole 3%, quetiapine 3%, and olanzapine 1%. Antipsychotics were generally prescribed in their recommended doses. Almost all SGAs were prescribed as polypharmacy, and the most common combination of SGAs were risperidone and clozapine. Conclusions This study highlighted that risperidone was the major choice for treatment in the outpatient setting. Polypharmacy is the most common pattern prescription of SGAs in the National Mental Hospital in Indonesia. New studies should focus on the analyses of polypharmacy prospectively, and the role of pharmacist in collaboration with other health professionals in the managing of schizophrenia therapy.

An Investigation of Spectrum of Diseases and Medication Use in Discharged Patients with Mental Disorders in the Inner Mongolia Autonomous Region

“…As clinicians are gaining understanding in mental disorders and accumulating experience in the treatment, the situation of patients with mental disorders has improved greatly, and new drug are being developed and promoted. According to the present study, the use of atypical antipsychotics was dominant (95.78%), which is in line with the result of the studies conducted by Liu and Julaeha [7][8] . Compared to typical antipsychotics, atypical antipsychotics are associated with a higher response rate, lower rate of treatment discontinuation, higher subjective comfort level of patients with mental disorders [9] , lower risks for metabolic syndrome and cardiovascular diseases [10] , and de nite therapeutic effect.…”

Metabolic Syndrome Risk Associated with Atypical Antipsychotic Medication: A Case Report

“…Currently, atypical antipsychotics recommended as first choice in schizophrenia medication rather than typical antipsychotics regarding low risk extrapyramidal side effects, non-adherence, and quality of life improvement 8,9 . Nevertheless, the use of antipsychotics especially atypical antipsychotics such as clozapine, olanzapine, quetiapine, and risperidone are associated with metabolic syndrome events 1 .…”

The therapeutic outcomes and adverse drug reactions study of Clozapine on Schizophrenia inpatients in the Grhasia psychiatric hospital Yogyakarta, Indonesia

“…Alongside a psychosocial rehabilitation program, antipsychotic agents are the drugs of choice to treat schizophrenia. Studies suggested that atypical antipsychotics resulted in better treatment retention and were more effective in preventing schizophrenia relapse than typical antipsychotics (Juleha et al, 2019).…”

“…This study showed that clozapine was the most used medication in combination with risperidone. A previous study reported that clozapine (38%) was the second most commonly prescribed atypical antipsychotic, in monotherapy or combined with other antipsychotics, to treat schizophrenia resistance (Juleha et al, 2019). Clozapine showed to be superior in managing treatment-resistant schizophrenia or among patients with suicide risk (Dipiro et al, 2017).…”