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Description of long-term polypharmacy among schizophrenia outpatients

  • Jaana T. SuokasEmail author
  • Jaana M. Suvisaari
  • Jari Haukka
  • Pasi Korhonen
  • Jari Tiihonen
Original Paper

Abstract

Objective

This large nationwide study describes the prevalence and predictors of long-term antipsychotic polypharmacy among patients with schizophrenia.

Methods

A register-based longitudinal study of all people in Finland, who had at least one hospitalization due to schizophrenia during the years 2000–2007 and who were alive on March 1, 2007. Entry to the cohort was defined from the first hospitalization for schizophrenia during the years 2000–2007, and the date of assessment of antipsychotic polypharmacy was March 1, 2007. We studied separately chronic (N = 8,037) and recent onset (N = 8,046) schizophrenia patients. Antipsychotic polypharmacy was defined as overlapping of two or more filled prescriptions of antipsychotics for over 60 days.

Results

In a total 16,083 patients with schizophrenia the prevalence of antipsychotic polypharmacy was 46.2 % (N = 7,436, mean age 47.5 years, male 55 %). The longer the duration of schizophrenia, the more common the antipsychotic polypharmacy. Long index hospitalization and being male significantly associated with antipsychotic polypharmacy among all schizophrenia patients. Especially, in chronic schizophrenia patients, the previous use of benzodiazepine like agents was associated with antipsychotic polypharmacy, but the use of antidepressants associated with less frequent antipsychotic polypharmacy.

Conclusions

Antipsychotic polypharmacy was widely prevalent among patients with schizophrenia and it was associated with long hospitalizations and long duration of illness. Benzodiazepine use was associated with increased risk and antidepressant use with decreased risk of antipsychotic polypharmacy when the effect of other clinical and socioeconomic factors was adjusted. Research is needed of risks and benefits of antipsychotic polypharmacy and augmentation of antipsychotic with other psychoactive drugs.

Keywords

Schizophrenia Antipsychotics Polypharmacy Long-term Outpatient treatment 

Notes

Acknowledgments

This study was supported by Janssen-Cilag.

Conflict of interest

The authors declare no conflict of interest.

Supplementary material

127_2012_586_MOESM1_ESM.doc (61 kb)
Supplementary material 1 (DOC 61 kb)

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Jaana T. Suokas
    • 1
    • 2
    • 9
    Email author
  • Jaana M. Suvisaari
    • 1
  • Jari Haukka
    • 3
    • 4
  • Pasi Korhonen
    • 3
    • 5
  • Jari Tiihonen
    • 1
    • 6
    • 7
    • 8
  1. 1.Department of Mental Health and Alcohol ResearchNational Institute for Health and WelfareHelsinkiFinland
  2. 2.Department of PsychiatryHelsinki University Central HospitalHelsinkiFinland
  3. 3.EPID Research OyEspooFinland
  4. 4.School of Health SciencesUniversity of TampereTampereFinland
  5. 5.StatFinn OyEspooFinland
  6. 6.Department of Clinical Neuroscience/PsychiatryKarolinska InstitutetStockholmSweden
  7. 7.Department of Forensic Psychiatry, Niuvanniemi HospitalUniversity of Eastern FinlandKuopioFinland
  8. 8.Department of Clinical PhysiologyKuopio University HospitalKuopioFinland
  9. 9.Department of Mental Health and Substance Abuse ServicesNational Institute for Health and WelfareHelsinkiFinland

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