Differential Treatment Responses in Pakistani Schizophrenia Samples: Correlation with Sociodemographic Parameters, Drug Addiction, Attitude to the Treatment and Antipsychotic Agents (original) (raw)
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Pharmacoepidemiological survey of schizophrenia in Central India
International Journal of Research in Medical Sciences, 2014
Schizophrenia is a chronic and debilitating psychiatric illness consisting primarily of symptoms such as hallucinations and delusions, also termed as "positive" symptoms. In addition, individuals may experience "negative" symptoms which include loss of sense of pleasure, social withdrawal, impoverishment of thoughts and speech and flattening of affect. According to WHO estimates, schizophrenia affects approximately 24 million people worldwide. 1 The prevalence of schizophrenia varies across the world, within countries, and at the local and neighborhood level. 2,3 The most recent publications estimate that prevalence of schizophrenia ranges from 1.4 to 4.6 / 1000 and the median incidence varies from 0.15 to 0.20 / 1000 population/year 4,5 and it is higher (7 / 1000 population) in ABSTRACT Background: Schizophrenia is a chronic and debilitating psychiatric illness affecting around 0.3-0.7% of people at some point in their life. The rate of schizophrenia and related disorders is affected by some environmental factors and social variables. Therefore, pharmacoepidemiological survey of patients suffering from schizophrenia was carried out to analyze the sociodemographic profile and drug prescribing pattern. Methods: A prospective observational study was conducted in psychiatry OPD of a tertiary care hospital for nine months. Diagnosis of schizophrenia was made according to DSM IV-TR criteria. Prescriptions were analyzed for socio demographic details, distribution of subsets of disease and psychotropic drugs prescribed. Results: Amongst 196 cases analyzed, 55.61% were males, 69.9% were below 40 years, 52.04% unmarried, 61.22% belonged to low income group, 82.14% unemployed and 58.16% came from urban locality. Paranoid schizophrenia (79.59%) was the most common diagnosis and a total of 402 psychotropic drugs were prescribed. Average number of psychotropic drugs per prescription was 2.05. Atypical antipsychotics (80.09%) were prescribed more commonly than typical antipsychotics; olanzapine (42.48%) was the commonest antipsychotic drug followed by risperidone (21.68%), haloperidol (19.91%), quetiapine (7.96%), aripiprazole (4.42%) and clozapine (3.54%). As an adjunctive treatment escitalopram, clonazepam and carbamazepine were the commonly prescribed antidepressant, anxiolytic and antimanic agent respectively. Conclusion: Low socioeconomic status, unemployment, urban locality and living alone are the sociodemographic factors associated with schizophrenia. The treatment pattern observed correlates with the changing trends in the treatment of schizophrenia world over.
L'Encéphale
Data concerning the characteristics of patients with schizophrenia and their treatment in day hospitals are scarce. Guidelines for clinical practice are, however, regularly published. Recommendations from the 1994 Consensus Conference underline the necessity of antipsychotic monotherapy in the long term treatment of schizophrenia. In the US the Schizophrenia Patient Outcome Research Team (PORT) published in 1999 treatment recommendations concerning the use of antipsychotics in the acute phase and in maintenance. For maintenance, the recommended dose should be between 300 and 600 mg/day (CPZ equivalents) (recommendation n 4). The aim of this study is to establish the socio-demographic and clinical profile of patients according to the dose of antipsychotic medication prescribed. The study also examines the use of antipsychotic polypharmacy. of the study. For this study, 116 patients treated in 12 different day hospital units were recruited. Inclusion criteria were: a DSM IV diagnosis ...
International Journal of Contemporary Medical Research [IJCMR], 2018
Introduction: Schizophrenia a backbone of psychiatry is challenge to modern psycho-pharmacotherapy. The psychotrophics like first and second-generation antipsychotics are the main form of treatment in schizophrenia. These drugs have several short-term, as well long-term advantages, and help to reduce symptomatologies but adherence to medication especially oral medication is always an issue. Therefore, long-acting injectable antipsychotics are used in patients with schizophrenia for better outcome and quality of life. Aims and Objectives of the study were to study the sociodemographic profile of schizophrenia patients who were on oral antipsychotics and long acting antipsychotic injectables. Material and Methods: The aim was to study Sociodemographic profile of Schizophrenia patients on oral and long acting antipsychotics. It was a cross-sectional observational study included all Schizophrenia patients with no history of any medical comorbidity. Sociodemographic profile was noted for each patient. Socioeconomic status was determined by Kuppuswamy's Scale. Results; In current study majority of patients on long acting injectable antipsychotics where from middle socioeconomic class with fair social support. Conclusion; The monthly expenditure of long acting antipsychotics especially second-generation seems to be expensive so, we conclude from this study that the price of long-acting antipsychotics should be reduced to a level of affordability of patients with minimal social support.
Changing trends in anti-psychotic prescription pattern in Pakistan
Pakistan Journal of Medical Sciences, 2019
Background and Objective: This study was designed to identify the changing trends in Antipsychotic prescription pattern in Pakistan. It was part of the research project Research on East Asian Psychotropic Prescription Pattern (REAP) carried out to identify the prescription patterns of schizophrenic patients in different countries located in Asia. Our objective was to assess the trend and change of psychotropic drug prescriptions for patients with schizophrenia. Methods: The design of the study was quantitative and of descriptive epidemiology. This study was carried out from 30th March 2017. Data was collected on a unified protocol by the Psychiatrists from Pakistan. Three (3) centers i.e., Lahore, Karachi and Islamabad provided the data. Indoor and outdoor cases with Schizophrenia were recruited. A web based recording system for collection of data done at Taipei Taiwan, and statistical analysis was performed and transferred to all participating centers including Pakistan. Results: T...
Indian Journal of Psychological Medicine, 2010
Background: Though there are several recommended guidelines for treating schizophrenia, in routine clinical practice, these are not followed. Aim: To conduct an audit of the prescription pattern of antipsychotic drugs in patients with schizophrenia, in a tertiary care centre in India, during a period of 1 year and compare it with Maudsley guidelines and Clinical practice guidelines for Psychiatrists in India (IPS guidelines). Materials and Methods: Data were collected from the case records, compiled, and analyzed. The concordance or discordance with Maudsley and IPS guidelines were studied. Results: The demographic variables of the patients and the prescription pattern of drugs were analyzed. The correlations between supramaximal and sub-threshold dosage of drugs to the gender, age, duration of illness, and combination of drugs were examined. Conclusions: Polypharmacy of antipsychotics is common. 31% of patients were on combination of typical and atypical antipsychotics. 4% of patients were receiving supramaximal dose of antipsychotics and all of them were on combination (P =<0.03, 2). 24% of patients were on sub-threshold doses. 83% were not on anticholinergic drugs.
Pakistan Journal of Medical and Health Sciences
Introduction: In schizophrenia, non-compliance with treatment leads to the disease burden in the community. It is considered as a challenge worldwide due to the need for long-term treatment and additional associated factors in Schizophrenia. Aim: The goal of the study is to identify patients with treatment non-compliance in schizophrenia and determine the related factors from environmental, socio-cultural and familial perspectives. Place and Duration: The study was carried out at the department of Behavioral Sciences, PGMI /AMC / LGH Lahore, Pakistan, from November 2021 to April 2022. Methods: The study included 100 patients with non-compliance to treatment in schizophrenia who visited the relevant psychiatric departments. For the research a descriptive cross-sectional design was chosen with non-random, purposive sample selection technique being utilised. Prior to the study, ethical approval from the authorities and informed consent from patients were obtained. Educated patients com...
Factors associated with psychotic relapse in patients with schizophrenia in a Pakistani cohort
International journal of mental health nursing, 2016
Despite a large body of research evaluating factors associated with the relapse of psychosis in schizophrenia, no studies in Pakistan have been undertaken to date to identify any such factors, including specific cultural factors pertinent to Pakistan. Semistructured interviews and psychometric measures were undertaken with 60 patients diagnosed with schizophrenia (49 male and 11 female) and their caregivers at four psychiatric hospitals in the Peshawar region in Pakistan. Factors significantly associated with psychotic relapse included treatment non-adherence, comorbid active psychiatric illnesses, poor social support, and high expressed emotion in living environments (P < 0.05). The attribution of symptoms to social and cultural values (97%) and a poor knowledge of psychosis by family members (88%) was also prevalent. In addition to many well-documented factors associated with psychotic relapse, beliefs in social and cultural myths and values were found to be an important, and p...