Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2016-0088
Trends in Psychiatry and Psychotherapy
Original Article

Psychotropic prescriptions for the treatment of schizophrenia in an outpatient clinic

Prescrições psicotrópicas para o tratamento da esquizofrenia em uma clínica ambulatorial

Christopher Izehinosen Okpataku; David Tawani

http://dx.doi.org/10.1590/2237-6089-2016-0088 Trends Psychiatry Psychother, vol.39, n3, p.165-172, 2017
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Abstract

Abstract Introduction There is an unpredictable pattern in the prescription of antipsychotics and other psychotropic medications for the treatment of schizophrenia, particularly in resource-limited settings in developing countries. Objective To determine the psychotropic prescriptions given to patients with schizophrenia in an outpatient clinic of a tertiary hospital and to describe the choices and trends of these prescriptions. Methods This was a cross-sectional descriptive study of prescriptions for adults with schizophrenia. After clinical consultation, patients’ case notes were randomly selected over a period of 2 years. Using a structured form, data were extracted from the case notes including biodemographic data, psychotropic medications prescribed and changes made to these prescriptions. Data were analyzed by means of descriptive statistics. Results A total of 103 patients were selected, with a mean age of 35.96±9.78 years; 48.5% were males and 51.5% were females; 33% were unemployed and 38% had been hospitalized in the past. There were 231 initial prescriptions and 228 current prescriptions, with about 2.2 prescriptions per patient. Haloperidol (mean dose 14.77±6.28mg and 11.44±5.55mg for initial and current) and other old-generation antipsychotics were the most commonly prescribed for new cases (98%). Mean duration of psychotropic use was 7.78±5.6 years. All the patients were prescribed trihexyphenidyl, and 56.3% of the patients had their medications changed as a result of side effects. Conclusion There was a very high preference for the use of first-generation antipsychotics for all treatment settings (in- and outpatients), a pattern that is likely to persist.

Keywords

Psychotropic, prescription, schizophrenia, clinic

Resumo

Resumo Introdução Existe um padrão imprevisível na prescrição de antipsicóticos e outros medicamentos psicotrópicos para o tratamento da esquizofrenia, especialmente em ambientes com limitação de recursos em países em desenvolvimento. Objetivo Determinar as prescrições psicotrópicas dadas a pacientes com esquizofrenia em uma clínica ambulatorial de um hospital terciário e descrever as escolhas e tendências dessas prescrições. Métodos Este foi um estudo descritivo transversal das prescrições dadas a adultos com esquizofrenia. Após consulta clínica, os prontuários dos pacientes foram selecionados aleatoriamente ao longo de um período de 2 anos. Usando um formulário estruturado, os dados foram extraídos dos prontuários, incluindo dados biodemográficos, medicamentos psicotrópicos prescritos e mudanças feitas a essas prescrições. Os dados foram analisados por meio de estatística descritiva. Resultados Um total de 103 pacientes foram selecionados, com idade média de 35,96±9,78 anos; 48,5% eram do sexo masculino e 51,5% do sexo feminino; 33% estavam desempregados e 38% haviam sido hospitalizados no passado. Houve 231 prescrições iniciais e 228 prescrições atuais, com aproximadamente 2,2 prescrições por paciente. O haloperidol (dose média de 14,77±6,28mg e 11,44±5,55mg para prescrições inicial e atual) e outros antipsicóticos de primeira geração foram os mais comumente prescritos para casos novos (98%). A duração média do uso de psicotrópicos foi de 7,78±5,6 anos. Todos os pacientes receberam prescrição de triexifenidil, e 56,3% dos pacientes tiveram seus medicamentos alterados como resultado de efeitos colaterais. Conclusão Houve uma alta preferência pelo uso de antipsicóticos de primeira geração para todos os regimes de tratamento (internação e ambulatorial), um padrão que provavelmente persistirá.

Palavras-chave

Psicotrópico, prescrição, esquizofrenia, clínica

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