Schizophrenia and other psychotic disorders Multiple antipsychotic medications in individuals residing in care centers: is it necessary or a social financial loss?

Objective: The aim of this is to analyze the relation between individual or multiple drug administration patterns of individuals residing in care centers for disabled persons in Turkey and the population characteristics as well as the diagnoses.

Method: The target population of this study included those patients referring to psychiatric clinics for examination or control, and those residing in care centers, and those diagnosed with a psychotic disorder according to DSM-IV-TR and those individuals receiving antipsychotic medications. As an antipsychotic drug administration, use of these medications in efficient treatment dose was evaluated. More than one antipsychotic drug administration was considered to be multiple antipsychotic drug administration. Data acquired were analyzed with SPSS 16.0 software. For digital comparison of groups, chi-square test was applied while for mean comparisons, t test was applied. P<0.005 was considered to be significant.

Results: 200 individuals residing in care centers were contacted. Single antipsychotic drug administration ratio was 38%, while double antipsychotic drug administration ratio was 34%, and more than three antipsychotic drug administration ratio was 28%. As single antipsychotic drug administration olanzapine was the most frequently used option, and for double antipsychotic drug administration olanzapine-quetiapine combination was the most frequently preferred one. Other antipsychotic combination were preferred as depot antipsychotic drug administration . Single depot antipsychotic drug use was less. Use of multiple antipsychotics was detected to be more in those patients suffering with schizophrenia and schizoaffective disorder, in young patients, and those attempting suicide as well as those with higher clinic severity.

Conclusion: Despite the fact that use of multiple antipsychotics is suggested in treatment directions as last option in patients resisting the treatment, and that they could be used in short terms during the antipsychotic switch, they are frequently administered. In addition, there were no studies concerning the use of antipsychotics in care centers in our country, and this condition has generally been neglected. Severity of disease is extremely high in the group using multiple antipsychotic drugs. Anyway, it is reported that use of antipsychotics enhances the mortality, morbidity, adverse effect