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Effects of antipsychotic polypharmacy on side‐effects and concurrent use of medications in schizophrenic outpatients
Author(s) -
Hashimoto Yasuhiko,
Uno Junji,
Miwa Takaichi,
Kurihara Masaaki,
Tanifuji Hiroaki,
Tensho Masami
Publication year - 2012
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/j.1440-1819.2012.02376.x
Subject(s) - polypharmacy , antipsychotic , schizophrenia (object oriented programming) , medicine , psychiatry , psychology , pharmacology
Aims:  Medical therapy is the cornerstone of schizophrenia, but >50% of patients do not adhere to medication regimens. In previous reports, the reasons for non‐adherence were assessed only by medical staff. We think that patients have specific reasons for non‐adherence. We researched whether there was an association between patients' subjective opinions and the number of antipsychotics used. Methods:  A self‐rating questionnaire survey was conducted on 252 outpatients with schizophrenia at five psychiatric hospitals in Japan. Based on patients' subjective opinions, we retrospectively analyzed the patients' medications: the number of antipsychotics, concurrently used agents, and dosages of antipsychotics. Results:  There was no significant difference regarding attitudes toward medication between monotherapy and polypharmacy. The most common reason for not taking medications was ‘I sometimes forget’ followed by ‘side‐effects’. Of the latter, weight gain was the most common, and dry mouth ( P  < 0.05) and sexual dysfunction ( P  < 0.01) were significantly higher in polypharmacy. The dosages of antipsychotics ( P  < 0.01), concurrent use of anti‐Parkinsonian agents ( P  < 0.01), and the number of side‐effects ( P  < 0.01) were also higher in polypharmacy. Conclusions:  Patients had good attitudes toward medication but a higher prevalence of side‐effects was seen in polypharmacy of antipsychotics. Hence, monotherapy may be a more appropriate prescription with respect to side‐effects. By using monotherapy, patients may reduce feelings of discomfort due to side‐effects.

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