精神保健および精神医学の国際ジャーナル

Prescription Pattern of Second Generation Antipsychotics and Outcomes of Patients with Schizophrenia in an Indian Hospital

Mathew VK, Sam KG, Samuel B and Das AK

An observational study was carried out to assess the clinical characteristics of patients with schizophrenia and the treatment pattern of the disease in a tertiary care hospital of south India. A retrospective evaluation of the prescription pattern of second generation antipsychotics and the clinical outcome of patients diagnosed with Schizophrenia in a tertiary care Indian hospital. The influence of patient demographics like age, sex, family history, type of schizophrenia and treatment on the outcome of patient at the time of discharge and length of hospital stay were also evaluated. Among a total of 139 schizophrenic patients, majority were males 81 (58.27%) and the average age was 34.4 ± 11.9 y. A predominance of male patients below 40 years and females above 40 y were observed. Paranoid schizophrenia was the major subclass (63.3%). Paranoid schizophrenia was the most prevalent subclass. Second generation antipsychotics were the major class (93.5%) used, among which tablet olanzapine was prescribed maximum (54.7%). Inj. haloperidol was the major (15.8%) first generation antipsychotic used. Anxiolytics (57.5%) and anticholinergics (56.8%) were the major adjuvant drugs used. The average hospitalization period was 12.4 ± 8.4 days and majority (92.1%) improved at discharge. An overall male predominance of schizophrenia among male population, especially more in age group below 40 y and the female domination above 40 y of age was observed. Second generation antipsychotics were the major class of treatment provided among which olanzapine received maximum prescriptions. Haloperidol was the major drug used among first generation antipsychotics. For the management of schizoaffective disorders, mood stabilizers like lithium, anxiolytics like lorazepam, antidepressants like fluoxetine and sertraline were commonly prescribed. Anticholinergic like benzhexol was prescribed for controlling the extrapyramidal side effects of antipsychotics. The increasing trend of prescribing second generation antipsychotics reflect the efficacy and safety profile as compared to first generation antipsychotics. The present study revealed an increasing trend of Paranoid schizophrenia and the use of second generation antipsychotics improved outcomes like hospitalization period and clinical status at discharge.