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

BACKGROUND: 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) n...

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Autores principales: Anozie, Ihechiluru G., James, Bawo O., Omoaregba, Joyce O., Oriji, Sunday O., Erohubie, Paul O., Enebe, Anthony C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082254/
https://www.ncbi.nlm.nih.gov/pubmed/35547105
http://dx.doi.org/10.4102/sajpsychiatry.v28i0.1791
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author Anozie, Ihechiluru G.
James, Bawo O.
Omoaregba, Joyce O.
Oriji, Sunday O.
Erohubie, Paul O.
Enebe, Anthony C.
author_facet Anozie, Ihechiluru G.
James, Bawo O.
Omoaregba, Joyce O.
Oriji, Sunday O.
Erohubie, Paul O.
Enebe, Anthony C.
author_sort Anozie, Ihechiluru G.
collection PubMed
description BACKGROUND: 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. AIM: 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. SETTING: The Federal Neuro-Psychiatric Hospital, Benin-City, Nigeria. METHODS: 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. RESULTS: 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. CONCLUSION: We conclude that although the use of HDAP amongst patients with schizophrenia remains common, its persistent use should be discouraged.
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spelling pubmed-90822542022-05-10 Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital Anozie, Ihechiluru G. James, Bawo O. Omoaregba, Joyce O. Oriji, Sunday O. Erohubie, Paul O. Enebe, Anthony C. S Afr J Psychiatr Original Research BACKGROUND: 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. AIM: 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. SETTING: The Federal Neuro-Psychiatric Hospital, Benin-City, Nigeria. METHODS: 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. RESULTS: 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. CONCLUSION: We conclude that although the use of HDAP amongst patients with schizophrenia remains common, its persistent use should be discouraged. AOSIS 2022-04-29 /pmc/articles/PMC9082254/ /pubmed/35547105 http://dx.doi.org/10.4102/sajpsychiatry.v28i0.1791 Text en © 2022. The Authors https://creativecommons.org/licenses/by/4.0/Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Original Research
Anozie, Ihechiluru G.
James, Bawo O.
Omoaregba, Joyce O.
Oriji, Sunday O.
Erohubie, Paul O.
Enebe, Anthony C.
Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital
title Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital
title_full Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital
title_fullStr Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital
title_full_unstemmed Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital
title_short Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital
title_sort correlates of high-dose antipsychotic prescription amongst outpatients with schizophrenia in a nigerian hospital
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082254/
https://www.ncbi.nlm.nih.gov/pubmed/35547105
http://dx.doi.org/10.4102/sajpsychiatry.v28i0.1791
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