Use of psychiatric medications in schizophrenia and other psychoses in a general population sample

Nykänen, Salla; Puska, Virpi; Tolonen, Jussi-Pekka; Salo, Henri; Isohanni, Matti; Koponen, Hannu; Pirkola, Sami; Penttilä, Matti; Haapea, Marianne; Moilanen, Jani; Jääskeläinen, Erika

doi:10.1016/j.psychres.2015.11.013

Cited by 12 publications

(14 citation statements)

References 31 publications

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“…[11] This study addresses the important issue of regular BZD prescription in rural community-dwelling patients with psychotic disorders. It is well documented that mental health-care services remain inaccessible to rural communities for several reasons, including geographical barriers, economic constraints, and lack of resources, such as insufficient number of trained professionals.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study from Finland reported a rate of BZD use by a sample of 55 patients with schizophrenia as high as 42% whereas 24% of patients were receiving BZD regularly. [11] The aim of the present study was to explore the long-term BZD use by community-dwelling patients with psychotic disorders, who regularly attend a mental health service within the primary care setting in rural and remote areas of Greece and to enquire for factors that may be associated with such use.…”

Section: Introductionmentioning

confidence: 99%

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Long-term Benzodiazepine Treatment in Patients with Psychotic Disorders Attending a Mental Health Service in Rural Greece

Peritogiannis¹,

Manthopoulou²,

Mavreas

2016

Journal of Neurosciences in Rural Practice

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Introduction:Long-term benzodiazepine (BZD) treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited.Materials and Methods:Information for 77 patients with psychotic disorders who were regularly attending follow-up appointments with the multidisciplinary Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Northwest Greece, during 1-year period (2015) was obtained from our database.Results:From the total of 77 engaged patients, 30 (39%) were regularly prescribed BZDs in the long term, as part of their treatment regimen. Prescribed BZDs were mostly diazepam and lorazepam, in 43.3% of cases each. The mean daily dose of these compounds was 13 mg and 3.77 mg, respectively. Statistical analysis showed a correlation of long-term BZD use with the history of alcohol/substance abuse. Most patients were receiving BZD continuously for several years, and the mean dose was steady within this interval.Conclusions:A large proportion of patients with psychotic disorders were regularly prescribed BZD in long term. It appears that when BZDs are prescribed for some period in the course of a psychotic disorder, their use commonly exceeds the recommended interval and then becomes a regular part of the chronic treatment regimen. Future research should address the factors that may be related to the long-term BZD use by patients with psychotic disorders. Interventions for the reduction of regular BZD prescription should target the primary care setting and all those who treat first episode patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term Benzodiazepine Treatment in Patients with Psychotic Disorders Attending a Mental Health Service in Rural Greece

Peritogiannis¹,

Manthopoulou²,

Mavreas

2016

Journal of Neurosciences in Rural Practice

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“…In their review, Correll et al highlight key issues regarding the long‐term use of these medications. Herein we further discuss such issues, based on additional literature and data from Finnish cohort studies.…”

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confidence: 99%

“…In addition, careful documentation of response, continuity, and coordination of care should be ensured by a well‐trained multidisciplinary team. However, in clinical practice, medication management is often suboptimal. Schizophrenia patients with impaired cognition or motivation and/or poor financial resources have an elevated risk of inadequate medication management.…”

mentioning

confidence: 99%

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Under‐utilized opportunities to optimize medication management in long‐term treatment of schizophrenia

et al. 2018

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Medication management of antipsychotic treatment in schizophrenia—A narrative review

Isohanni

Jääskeläinen

Miller

et al. 2020

Human Psychopharmacology

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Background/Objective: The risk-benefit ratio of antipsychotics in schizophrenia depends primarily on their effect on brain chemistry. An important factor influencing the efficacy of prescribed drugs is medication management, which can be defined as an ongoing process to manage and monitor the recommended use of antipsychotics to facilitate their cost-effective, adherent, and acceptable use. Materials: We reviewed narratively relevant literature that examined the medication management of antipsychotics in schizophrenia based on a search of PubMed, Scopus, Web of Science, PsycARTICLES, and Cochrane in May 2020. We also included controlled interventional studies with a follow-up period of at least 2 years. Result: Based on the previous literature, there is no unified approach for optimal medication management, but multiple useful strategies are presented for individual patients, prescribers, and organizations. Conclusions: Systematic medication management may improve the risk-benefit balance of antipsychotics by achieving the lowest effective dose, minimizing adverse effects, and improving adherence. There is a need for well-designed naturalistic studies and clinical trials to optimize management in schizophrenia.

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Use of psychiatric medications in schizophrenia and other psychoses in a general population sample

Cited by 12 publications

References 31 publications

Long-term Benzodiazepine Treatment in Patients with Psychotic Disorders Attending a Mental Health Service in Rural Greece

Long-term Benzodiazepine Treatment in Patients with Psychotic Disorders Attending a Mental Health Service in Rural Greece

Under‐utilized opportunities to optimize medication management in long‐term treatment of schizophrenia

Medication management of antipsychotic treatment in schizophrenia—A narrative review

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