Medication for psychosis--consumption and consequences: the second Australian national survey of psychosis.
BACKGROUND
Most people diagnosed with a psychotic disorder will be prescribed psychotropic medication. The second Australian national survey of psychosis provided a unique opportunity to examine the pharmacological treatment of psychotic disorders from the perspective of the consumer. The aim of this paper is to report on medication use, adherence and perceived efficacy, and to describe side effect profiles.


METHODS
Data on self-reported medication use in the 4 weeks prior to interview, including type, duration, adherence, side effects and helpfulness was collected from participants interviewed in the course of the second Australian national survey of psychosis.


RESULTS
The majority (91.6%) of participants were using psychotropic medication: 89.0% of people aged 18-34 years and 93.5% of people aged 35-64 years. The most commonly used class of medication was antipsychotic medication (81.6%). In addition, 37.4% were using antidepressants, 26.7% were using mood stabilisers and 17.8% were using anxiolytics/hypnotics. Polypharmacy was common with almost two-thirds (63.4%) using more than one class of medication and over a quarter (28.1%) of people with schizophrenia using more than one antipsychotic. Many participants (84.4%) reported experiencing side effects. The side effect profile of people using atypical antipsychotics was on average better than that of people using typical antipsychotics. Most people (85.2%) felt their medication relieved their mental health symptoms and most (88.2%) medication was taken as prescribed.


CONCLUSIONS
Many people with a psychotic disorder are receiving antipsychotics, with a substantial proportion also taking antidepressants, mood stabilisers and anxiolytics/hypnotics. Medication use differs by age group, diagnostic group and course of illness. Many people using antipsychotics describe significant impairment in their everyday life as a result of medication side effects. Users of typical antipsychotics reported more side effects and more impairment than people using atypical antipsychotics. Most of our participants were prescribed psychotropic medications, and most reported that they were taking them.
Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia. anna.waterreus@uwa.edu.au
Anna
A
Waterreus
Vera A
VA
Morgan
David
D
Castle
Cherrie
C
Galletly
Assen
A
Jablensky
Patsy
P
Di Prinzio
Sonal
S
Shah
D000328:Adult; D001315:Australia / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D060735:Pharmacovigilance; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D057566:Self Report; D016896:Treatment Outcome; D016903:Drug Monitoring
D055553:Prescription Drugs; D011619:Psychotropic Drugs