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. 2022 Apr 29:28:1791.
doi: 10.4102/sajpsychiatry.v28i0.1791. eCollection 2022.

Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital

Ihechiluru G Anozie  1 , Bawo O James  1 , Joyce O Omoaregba  1 , Sunday O Oriji  1   2 , Paul O Erohubie  1   3 , Anthony C Enebe  1   4
Affiliations

Correlates of high-dose antipsychotic prescription amongst outpatients with Schizophrenia in a Nigerian Hospital

Ihechiluru G Anozie et al. S Afr J Psychiatr. .

Abstract

Background: Treatment guidelines recommend the use of antipsychotic monotherapy at effective doses for the treatment of schizophrenia, although about a third of the sufferers still receive high-dose antipsychotic treatment. Current evidence suggests that high-dose antipsychotic prescription (HDAP) not only fails to improve outcomes but also increases side effects.

Aim: Our study aimed to determine the prevalence of HDAP and its association with illness severity, medication adherence behaviour and side effects amongst outpatients with schizophrenia.

Setting: The Federal Neuro-Psychiatric Hospital, Benin-City, Nigeria.

Methods: A cross-sectional study of 320 attendees with schizophrenia at the outpatient department was undertaken. We administered a sociodemographic and antipsychotic medication questionnaire, Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale, Liverpool University Neuroleptic Side Effects Rating Scales and Medication Adherence Rating Scales. High-dose antipsychotic prescription was determined by the ratio of prescribed daily dose to defined daily dose greater than 1.5.

Results: The prevalence of HDAP was 38.4%. Greater severity of illness, experiencing more side effects and poor medication adherence were significantly associated with HDAP.The major predictors of HDAP were antipsychotic polypharmacy and concurrent anticholinergic use.

Conclusion: We conclude that although the use of HDAP amongst patients with schizophrenia remains common, its persistent use should be discouraged.

Keywords: Nigeria; antipsychotics; high dose; prescription; schizophrenia.

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Conflict of interest statement

The authors have declared that no competing interest exists.

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