Pattern of Antipsychotics in Schizophrenia Outpatients at Lampung Province Mental Hospital
DOI:
https://doi.org/10.36733/medicamento.v8i1.3201Keywords:
combination antipsychotics, outpatients, SchizophreniaAbstract
Schizophrenia as a chronic mental disorder, has increased in number in the last three decades DALYs (Disability Adjusted Life Years). Antipsychotics have been the mainstay of treatment. The use of combinations of typical/atipycal antipsychotic active substances is very often done. The purpose of this study was to look at patient characteristics and clinical characteristics including the number and type of antipsychotic combinations. This research is descriptive research with a quantitative and cross-sectional approach. Data age, gender, duration of illness, financing status, number of drugs, and the name of the antipsychotic used were taken from medical records and prescription sheets from 207 outpatients diagnosed with schizophrenia. The data was then processed and analyzed using univariate analysis. Outpatient schizophrenia patients were dominated by 62.8% male, aged 26-35 years 32.4%, duration of illness more than 12 months was 92.3%, 82.8% used health insurance, the average number of drugs prescribed was 3.5 drugs. The combination with two antipsychotics was 58%. The atypical-typical combinations (30.9%) were higher with the most risperidone-clozapine. Typical-typical combinations (19.3%) included chlorpromazine-haloperidol, trifluoperazine-chlorpromazine. Atypical-atypical combinations include risperidone-clozapine. The combination of three antipsychotics reached 7.7%. The conclusion of this study shows that the combination of antipsychotics is widely used in the treatment of schizophrenia, with two types of antipsychotics being the most widely used. The combination of risperidone-chlorpromazine was the most common at 21.7%.
References
Alessi-Severini, S., Le Dorze, J. A., Nguyen, D., Honcharik, P., & Eleff, M. (2013). Clozapine prescribing in a Canadian outpatient population. PLoS ONE, 8(12), 8–11. https://doi.org/10.1371/journal.pone.0083539
Aryani, F., & Sari, O. (2016). Gambaran Pola Penggunaan Antipsikotik pada Pasien Skizofrenia di Ruang Rawat Inap Rumah Sakit Jiwa. Jurnal Manajemen Dan Pelayanan Farmasi, Volume 6 N, 35–40.
Ballon, J., & Stroup, T. S. (2013). Polypharmacy for schizophrenia. Current Opinion in Psychiatry, 26(2), 208–213. https://doi.org/10.1097/YCO.0b013e32835d9efb
Barnes, T. R. ., & Paton, C. (2011). Antipsychotic polypharmacy in schizophrenic inpatients. CNS Drugs, 25(5), 383–399.
Bondolfi, G., Dufour, Patris, M., May, J. ., Billeter, U., Eap, C. ., & Baumann, P. (1998). Risperidone versus clozapine in treatment-resistant schizophrenia: A randomized pilot study. American Journal of Psychiatry, 155(5), 499–504. https://doi.org/10.1016/S0278-5846(00)00118-4
Budiman, A., Khambri, D., & Bachtiar, H. (2013). Affecting’s factor to medication adherence of patient with Tamoxifen after surgery. Jurnal FK Universitas Andalas, 2(1), 20–24.
Chen, A. T., & Nasrallah, H. A. (2019). Neuroprotective effects of the second generation antipsychotics. Schizophrenia Research, 208, 1–7. https://doi.org/10.1016/j.schres.2019.04.009
Emiliana, N., Fauziah, M., Hasanah, I., & Fadlilah, D. R. (2021). Analisis Kepatuhan Kontrol Berobat Pasien Hipertensi Rawat Jalan Pada Pengunjung Puskesmas Pisangan Tahun 2019. Jurnal Kajian Dan Pengembangan Kesehatan Masyarakat, 1, 224–232.
Faden, J., Kiryankova-Dalseth, N., Barghini, R., & Citrome, L. (2021). Does antipsychotic combination therapy reduce the risk of hospitalization in schizophrenia? Expert Opinion on Pharmacotherapy, 22(5), 635–646. https://doi.org/10.1080/14656566.2020.1847274
Gogos, A., Sbisa, A. M., Sun, J., Gibbons, A., Udawela, M., & Dean, B. (2015). A Role for Estrogen in Schizophrenia: Clinical and Preclinical Findings. International Journal of Endocrinology, 2015. https://doi.org/10.1155/2015/615356
Handayani, D. S., Cahaya, N., & Srikartika, V. M. (2017). Pengaruh Pemberian Kombinasi Antipsikotik Terhadap Efek Samping Sindrom Ekstrapiramidal Pada Pasien Skizofrnia di Rumah Sakit Jiwa Sambang Lihum. Farmaka, 15(3), 86–95.
Heald, A., Livingston, M., Yung, A., & De Hert, M. A. (2017). Prescribing in schizophrenia and psychosis: Increasing polypharmacy over time. Human Psychopharmacology, 32(2), 1–4. https://doi.org/10.1002/hup.2579
Hendra, G. A. (2020). Analisis Hubungan Kualitas Hidup Terhadap Penggunaan Kombinasi Obat Antipsikotik Pada Pasien Skizofrenia. Jurnal Kesehatan Dr. Soebandi, 8(2), 128–134. https://doi.org/10.36858/jkds.v8i2.229
Hs, T., Williams, T., Siegfried, N., & Dj, S. (2018). Risperidone versus other antipsychotics for people with severe mental illness and co-occurring substance misuse ( Review ). 1. https://doi.org/10.1002/14651858.CD011057.pub2.www.cochranelibrary.com
Huhn, M., Nikolakopoulou, A., Schneider-Thoma, J., Krause, M., Samara, M., Peter, N., Arndt, T., Bäckers, L., Rothe, P., Cipriani, A., Davis, J., Salanti, G., & Leucht, S. (2019). Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. The Lancet, 394(10202), 939–951. https://doi.org/10.1016/S0140-6736(19)31135-3
Karaeng, N. D., Makhmud, A. I., & Liaury, K. (2021). The use of risperidone-combination and haloperidol-combination in schizophrenia patients: A cost utility analysis in psychiatric hospital of Prof. V.L. Ratumbuysang. Medicina Clínica Práctica, 4, 100236. https://doi.org/10.1016/j.mcpsp.2021.100236
Kasteridis, P., Ride, J., Gutacker, N., Aylott, L., Dare, C., Doran, T., Gilbody, S., Goddard, M., Gravelle, H., Kendrick, T., Mason, A., Rice, N., Siddiqi, N., Williams, R., & Jacobs, R. (2019). Association between antipsychotic polypharmacy and outcomes for people with serious mental illness in England. Psychiatric Services, 70(8), 650–656. https://doi.org/10.1176/appi.ps.201800504
Kb, S., Bo, L., Zhao, S., Xia, J., Sampson, S., & Ru, Z. (2016). Chlorpromazine versus atypical antipsychotic drugs for schizophrenia ( Review ) SUMMARY OF FINDINGS FOR THE MAIN COMPARISON. 4. https://doi.org/10.1002/14651858.CD010631.pub2.www.cochranelibrary.com
Kementrian Kesehatan RI. (2019). Situasi Kesehatan Jiwa DI Indonesia. In InfoDATIN (p. 12).
Kim, J. H., Kim, S. Y., Ahn, Y. M., & Kim, Y. S. (2006). Subjective response to clozapine and risperidone treatment in outpatients with schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30(2), 301–305. https://doi.org/10.1016/j.pnpbp.2005.10.006
Komossa, K., Rummel-Kluge, C., Schwarz, S., Schmid, F., Hunger, H., Kissling, W., & Leucht, S. (2011). Risperidone versus other atypical antipsychotics for schizophrenia. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd006626.pub2
Li, R., Ma, X., Wang, G., Yang, J., & Wang, C. (2016). Why sex differences in schizophrenia? HHS Public Access. J Transl Neurosci (Beijing), 1(1), 37–42.
Liberty, I. A., Pariyana, P., Roflin, E., & Waris, L. (2018). Determinan Kepatuhan Berobat Pasien Hipertensi Pada Fasilitas Kesehatan Tingkat I. Jurnal Penelitian Dan Pengembangan Pelayanan Kesehatan, 1(1), 58–65. https://doi.org/10.22435/jpppk.v1i1.428
Maylani, R. Y., Fadraersada, J., & Ramadhan, A. M. (2018). Studi Pemberian Antipsikotik terhadap Beberapa Jenis Skizofrenia Di RSJD Atma Husada Mahakam Samarinda. Proceeding of Mulawarman Pharmaceuticals Conferences, 8(November), 267–275. https://doi.org/10.25026/mpc.v8i1.333
Ochoa, S., Usall, J., Cobo, J., Labad, X., & Kulkarni, J. (2012). Gender Differences in Schizophrenia and First-Episode Psychosis: A Comprehensive Literature Review. Schizophrenia Research and Treatment, 2012, 1–9. https://doi.org/10.1155/2012/916198
Oommen, S., P, E., C, A., & Solomon, S. (2019). Assessment of drug prescribing pattern in schizophrenia in a tertiary care hospital in South India. National Journal of Physiology, Pharmacy and Pharmacology, 9(7), 1. https://doi.org/10.5455/njppp.2019.9.0516503052019
Pandarakalam, J. P. (2019). Combination therapy for treatment resistant schizophrenia. British Journal of Medical Practitioners, 12(2).
Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: Overview and treatment options. P and T, 39(9), 638–645.
Rathbone, J., Adams, C. E., Thornley, B., Clarke, M., Borrill, J., Wahlbeck, K., & Awad, A. G. (2005). Chlorpromazine for schizophrenia: A cochrane systematic review of 50 years of randomised controlled trials. BMC Medicine, 3(February). https://doi.org/10.1186/1741-7015-3-15
Salwan, J., Woldu, H., Rosen, A., & Katz, C. L. (2013). Application for Inclusion to the 19th Expert Committee on the Selection and Use of Essential Medicines: Risperidone. http://www.who.int/selection_medicines/committees/expert/19/applications/Risperidone_24_A_Ad_Final.pdf
Semahegn, A., Torpey, K., Manu, A., Assefa, N., Tesfaye, G., & Ankomah, A. (2018). Psychotropic medication non-adherence and associated factors among adult patients with major psychiatric disorders : a protocol for a systematic review. 1–5. https://doi.org/10.1186/s13643-018-0676-y
Syamsuddin, S., Limoa, E., Mandan, I., & Lisal, S. T. (2020). Comparison Between Combination Of Risperidone And Haloperidol Therapy With Combination Of Risperidone And Chlorpromazine Therapy On Clinical. 7(13), 1717–1721.
Tiihonen, J., Taipale, H., Mehtälä, J., Vattulainen, P., Correll, C. U., & Tanskanen, A. (2019). Association of Antipsychotic Polypharmacy vs Monotherapy with Psychiatric Rehospitalization among Adults with Schizophrenia. JAMA Psychiatry, 76(5), 499–507. https://doi.org/10.1001/jamapsychiatry.2018.4320
Warnez, S., & Alessi-Severini, S. (2014). Clozapine: A review of clinical practice guidelines and prescribing trends. BMC Psychiatry, 14(1). https://doi.org/10.1186/1471-244X-14-102
Weiser, M., Levi, L., Zamora, D., Biegon, A., Sangiovanni, J. P., Davidson, M., Burshtein, S., Gonen, I., Radu, P., Slobozean Pavalache, K., Nastas, I., Hemi, R., Ryan, T., & Davis, J. M. (2019). Effect of Adjunctive Estradiol on Schizophrenia among Women of Childbearing Age: A Randomized Clinical Trial. JAMA Psychiatry, 76(10), 1009–1017. https://doi.org/10.1001/jamapsychiatry.2019.1842
Yulianty, M. D., Cahaya, N., & Srikartika, V. M. (2017). Antipsychotics use and side effects in patients with schizophrenia at Sambang Lihum Hospital South Kalimantan, Indonesia. Jurnal Sains Farmasi & Klinis, 3(2), 153–164.
Zahnia, S., & Wulan Sumekar, D. (2016). Kajian Epidemiologis Skizofrenia. Majority, 5(5), 160–166.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Jurnal Ilmiah Medicamento
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The copyright holder for the work is the Jurnal Ilmiah Medicamento.
Jurnal Ilmiah Medicamento is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- The licensor cannot revoke these freedoms if you follow the license terms.
Under the following terms:
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so reasonably but not in any way that suggests the licensor endorses you or your use.
-
NonCommercial — You may not use the material for commercial purposes.
-
NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.