The effects of one community mental health center on antipsychotic polypharmacy: 12-months follow-up of patients with schizophrenia

Abstract

Objective: Treatment with multiple antipsychotic medications (antipsychotic polypharmacy [APP]) in schizophrenia is recommended to be considered as a last resort, due to non-compliance, metabolic side effects and high mortality. On the other hand, in current clinical practice, APP is quite commonplace. The effects of one “community mental health center” (CMHC) activities on APP and clinical symptoms of enrolled schizophrenia patients were investigated in order to determine changes on antipsychotic treatment processes for schizophrenia. Methods: Sociodemographic Data Form, Positive and Negative Symptom Scale for Schizophrenia (PANSS) scores, Pharmacotherapy Compliance Scale evaluations and modes of medication utilization of 120 patients who were followed-up in this center for one year were evaluated retrospectively. Results: All PANSS subscale (positive, negative and general) scores of the patients decreased and compliance with drug treatment increased; rates of APP remained the same and mean drug treatment doses did not change. Conclusion: The insistence on APP, in spite of improvements in symptoms and patient compliance, shows the importance of maintaining community mental health activities as well as interventions targeting prescription habits of psychiatrists. Such interventions can provide a decrease in use of multiple medications. Results indicate the need to utilize community mental health center services to increase the effectiveness of psychopharmacotherapy for schizophrenia.