Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital.

Journal: The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa

Volume: 28

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Clinical Sciences, Federal Neuropsychiatric Hospital, Benin City, Nigeria.

Abstract summary 

Treatment guidelines recommend the use of antipsychotic monotherapy at effective doses for the treatment of schizophrenia, although about a third of the sufferers still receive high-dose antipsychotic treatment. Current evidence suggests that high-dose antipsychotic prescription (HDAP) not only fails to improve outcomes but also increases side effects.Our study aimed to determine the prevalence of HDAP and its association with illness severity, medication adherence behaviour and side effects amongst outpatients with schizophrenia.The Federal Neuro-Psychiatric Hospital, Benin-City, Nigeria.A cross-sectional study of 320 attendees with schizophrenia at the outpatient department was undertaken. We administered a sociodemographic and antipsychotic medication questionnaire, Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale, Liverpool University Neuroleptic Side Effects Rating Scales and Medication Adherence Rating Scales. High-dose antipsychotic prescription was determined by the ratio of prescribed daily dose to defined daily dose greater than 1.5.The prevalence of HDAP was 38.4%. Greater severity of illness, experiencing more side effects and poor medication adherence were significantly associated with HDAP.The major predictors of HDAP were antipsychotic polypharmacy and concurrent anticholinergic use.We conclude that although the use of HDAP amongst patients with schizophrenia remains common, its persistent use should be discouraged.

Authors & Co-authors:  Anozie Ihechiluru G IG James Bawo O BO Omoaregba Joyce O JO Oriji Sunday O SO Erohubie Paul O PO Enebe Anthony C AC

Study Outcome 

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Statistics
Citations :  Sadock BJ, Sadock VA. Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 10th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2007.
Authors :  6
Identifiers
Doi : 1791
SSN : 1608-9685
Study Population
Male,Female
Mesh Terms
Other Terms
Nigeria;antipsychotics;high dose;prescription;schizophrenia
Study Design
Study Approach
Country of Study
Niger
Publication Country
South Africa