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Objective: Polypharmacy which means treatment with multiple drugs is commonly practiced by psychiatrists worldwide because of the reasons like treatment resistant cases, minimizing the side effects of medications and the fact that most psychiatric disorders are syndromes. Rational pharmacotherapy primarily considers mono pharmacy and aims to treat patients in an effective and reliable way based on evidence with a minimum number of drugs. Since we do not have any sufficient evidence concerning the effectiveness and reliability of polypharmacy, it seems that doctors recognize their own clinical experiences more than they consider published evidence. Studies about combined antipsychotic practices in Turkey seem to include patients, who had mostly the diagnosis of schizophrenia and were hospitalized in psychiatric wards of Mental Health and Diseases Hospitals, where more treatment resistant cases are hospitalized. A significant variation was found across three different Community Mental Health Centers, which took place in the same region of New Zealand in the prescription of antipsychotics to the recorded patients related to dosage, type of antipsychotics and method of practice. In this study antipsychotic usage of patients, who were recorded in Corum Community Mental Health Center with the diagnosis of psychotic disorders was evaluated.
Methods: Files of the patients who had been recorded in Corum Community Mental Health Center with the diagnosis of psychotic disorders (schizophrenia, schizoaffective disorder, non-organic psychosis) since it was established in 28th of October in 2011 were evaluated, retrospectively. Out of those of 127 patients who met those criteria, only 113 files whose data could be reached in full were included in the study.
Results: Forty (35,4%) women and 73 (64,6%) men with an average age of 41±11,6 years and average education period of 7±4,2 years participated in our study. Amongst 113 patients 49, (43,4%) were single, 44 (38,4%) were married, 8 (7,1%) were widowed and 12 (10,6%) were divorced. 23 (20,35%) patients were given only single drug treatment. Number of patients who were given combination drug treatment were 38 (33,63) % for two, 37 (32,74%) for three, 12 (10,2%) for four, 3 (2,65%) for five drugs combinations, respectively. It was found that 17 (15,4%) were using typical antipsychotics orally, while 5 (4,42%) were using typicals in depot form, 106 (93,81%) were using atypicals orally and 16 (14,16%) were using atypicals in depot form. 21 patients who were using depot antipsychotics were found to include 5 (23,81%) patients using only depot antipsychotics and 16 (76,19%) patients using both depot and oral antipsychotics.
Conclusion: Administration practices of typical antipsychotics and multiple drug treatment are common in our community mental health center as consistently reported in the literature. After the evaluation of patients, who are recorded in other similar centers, presentation of the variations across those centers will be possible.