Abstract
Objectives
This study aims to: (a) describe the type and doses of psychotropic drugs received by outpatients with schizophrenia in Italy; (b) explore the relationship between prescription and patients’ clinical conditions, disability and socio-demographic characteristics; and (c) estimate the percentage of patients receiving polypharmacy and antipsychotics within the official recommended ranges.
Methods
A total of 682 patients with schizophrenia were consecutively recruited in 30 Italian mental health departments, randomly selected taking into account the geographic location and population density of their catchment areas.
Results
Of the sample, 98% were in treatment with neuroleptics, 47% received benzodiazepines, 25% were on anticholinergics, 10% were prescribed antidepressants and 8% were on mood stabilisers. Polypharmacy was found in 29% of the sample. Patients treated with one neuroleptic received this within therapeutic doses in 77% of cases. In patients who received two neuroleptics (24%), the former was prescribed within the official range in 71% of cases and the latter in 46%. Polytherapy was more frequently prescribed in patients treated with typicals (60% versus 34%) and in those who also received benzodiazepines (61% versus 41%) and anticholinergics (44% versus 16%). Patients in treatment with atypicals (45%) were mainly younger and lived in highly populated areas. Depot medications (25%) were more frequently prescribed to patients living in areas of low population density, who were older and who had a lower educational level, a longer duration of illness and milder anxiety/depression symptoms.
Conclusions
The consistent percentage of patients receiving polypharmacy and neuroleptics outside the therapeutic doses highlights the need to promote interventions aimed at increasing a rational use of psychotropic drugs among mental health professionals.
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Acknowledgements
This study was supported by a grant from the National Mental Health Project, National Institute of Health, Italy (grant no. 96/Q/T/38). The following researchers contributed to data collection: Lara Adinolfi (Fermo), Valentina Aguglia (Palermo), Donatella Airoldi (Abbiategrasso), Adriano Aletti (Cremona), Simona Laura Benzi (Tortona), Marco Bertelli (Florence), Giuliana Boine (Settimo Torinese), Emi Bondi (Bormio), Federica Bortolazzi (Portomaggiore), Erica Brigidi (Ferentino), Carmen Cangiano (Gragnano), Anna Carniani (Castel del Piano), Simona Cesano (Turin), Angelo Cucciniello (Angri), Benedetto Del Vecchio (Barletta), Laura Di Fazio (Livorno), Simona Fazi and Valeria Modesti (Narni), Massimo Federici (La Spezia), Elisabetta Greco (Rome), Enrico La Delfa (Catania), Giovanni Marcone (Fondi), Angela Martino (Pace del Mela), Marco Nurra (Oristano), Gianluca Piemontese (Foggia), Flaminia Poletti (Ascoli Piceno), Antonella Sambuco (Squinzano), Claudio Scuto (Como), Patrizia Thei (Milan), Alberto Trisolini (Vetralla), Francesco Tuligi (Lanusei). We thank Dr. Rosa Colacino for her linguistic help in preparing the text.
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Magliano, L., Fiorillo, A., Guarneri, M. et al. Prescription of psychotropic drugs to patients with schizophrenia: an Italian national survey. Eur J Clin Pharmacol 60, 513–522 (2004). https://doi.org/10.1007/s00228-004-0803-7
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DOI: https://doi.org/10.1007/s00228-004-0803-7