Polypharmacy in Schizophrenic Inpatients: The Comparison between 1997 and 2003 in One University Hospital

Kim, Won; Bahk, Won Myong; Woo, Young Sup; Seo, Ho Jun; Jun, Tae Youn; Kim, Kwang Soo; Chae, Jeong Ho

Abstract

OBJECTIVE
Up to recently, the standard pharmacotherapy of schizophrenia has been monotherapy, use of one antipsychotic medication. However, polypharmacy in patients with schizophrenia is a common practice with little basis in well-controlled studies. In this study, we explored the patterns of pharmacotherapy in inpatient with schizophrenia by comparing prescribed medications at discharge between the year 1997 and the year 2003. METHODS: The medical records of patients who discharged with the diagnosis of schizophrenia from department of psychiatry, St. Mary's hospital in 1997 and 2003 were reviewed. The psychotropic medications at discharge were compared. The length of stay at the hospital and the incidence of adverse drug reactions were also compared. For statistics, chi-square test and independent t-test were performed. RESULTS: Data of 96 patients who discharged in 1997 and 2003 were analyzed. Patients prescribed with more than two kinds of antipsychotics were 7 of 96 in 1997 (7.2%) and 12 of 72 (16.7%), but the difference is not statistically significant (p=0.058). Patients prescribed with antipsychotics and mood stabilizers were 9 (9.3%) in 1997 and 18 (25%) in 2003. The difference is statistically significant (p=0.010). Especially, carbamazepine occupied most part of mood stabilizer use (89%) in 1997 but valproate use was increased much in 2003 (56%). Patients who were administered with anxiolytics (p=0.001) or anti-Parkinson agents (p<0.001) were decreased in 2003 compared with 1997. There were no statistically significant differences in the incidence of adverse drug reactions and the length of stay at the hospital. CONCLUSION: This study found that hospitalized patients with schizophrenia are being treated with more psychotropic medications, including more than 1 antipsychotic.