title: Effects of antipsychotic polypharmacy on side-effects and concurrent use of medications in schizophrenic outpatients.
abstract: OBJECTIVE
  Medical therapy is the cornerstone of schizophrenia, but >50% of patients do not adhere to medication regimens. In previous reports, the reasons for non-adherence were assessed only by medical staff. We think that patients have specific reasons for non-adherence. We researched whether there was an association between patients' subjective opinions and the number of antipsychotics used.
  
  
  METHODS
  A self-rating questionnaire survey was conducted on 252 outpatients with schizophrenia at five psychiatric hospitals in Japan. Based on patients' subjective opinions, we retrospectively analyzed the patients' medications: the number of antipsychotics, concurrently used agents, and dosages of antipsychotics.
  
  
  RESULTS
  There was no significant difference regarding attitudes toward medication between monotherapy and polypharmacy. The most common reason for not taking medications was 'I sometimes forget' followed by 'side-effects'. Of the latter, weight gain was the most common, and dry mouth (P < 0.05) and sexual dysfunction (P < 0.01) were significantly higher in polypharmacy. The dosages of antipsychotics (P < 0.01), concurrent use of anti-Parkinsonian agents (P < 0.01), and the number of side-effects (P < 0.01) were also higher in polypharmacy.
  
  
  CONCLUSIONS
  Patients had good attitudes toward medication but a higher prevalence of side-effects was seen in polypharmacy of antipsychotics. Hence, monotherapy may be a more appropriate prescription with respect to side-effects. By using monotherapy, patients may reduce feelings of discomfort due to side-effects.
authors: Faculty of Clinical Pharmacy School of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan. yhashi@pharm.kobegakuin.ac.jp
authors: Yasuhiko
authors: Y
authors: Hashimoto
authors: Junji
authors: J
authors: Uno
authors: Takaichi
authors: T
authors: Miwa
authors: Masaaki
authors: M
authors: Kurihara
authors: Hiroaki
authors: H
authors: Tanifuji
authors: Masami
authors: M
authors: Tensho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010045:Outpatients; D019338:Polypharmacy; D012559:Schizophrenia / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D015430:Weight Gain; D014987:Xerostomia
chemical_list: D014150:Antipsychotic Agents