Schizophrenia is a chronic disorder that requires long-term treatment to achieve symptom remission and quality of life improvement. Antipsychotic medications are primary treatments for schizophrenia patients. Second-generation antipsychotics (SGAs) have been recognized as first-line drugs in the treatment of schizophrenia. This study aimed at determining the prescription patterns of SGAs in schizophrenia outpatients in the National Mental Hospital in Indonesia.
A retrospective study with descriptive analysis was conducted between October and December 2018, exclusive to data of the patients with schizophrenia only. Data were collected from the prescription records of schizophrenia outpatients. This study performed a descriptive analysis of patient characteristics, percentage of SGAs prescribed, regimen doses of SGAs, average number of SGAs prescribed per patient, and pattern of antipsychotics prescribed.
The most commonly used SGAs were risperidone 55%, followed by clozapine 38%, aripiprazole 3%, quetiapine 3%, and olanzapine 1%. Antipsychotics were generally prescribed in their recommended doses. Almost all SGAs were prescribed as polypharmacy, and the most common combination of SGAs were risperidone and clozapine.
This study highlighted that risperidone was the major choice for treatment in the outpatient setting. Polypharmacy is the most common pattern prescription of SGAs in the National Mental Hospital in Indonesia. New studies should focus on the analyses of polypharmacy prospectively, and the role of pharmacist in collaboration with other health professionals in the managing of schizophrenia therapy.
We acknowledge the head and all staffs of the national mental hospital for providing support and facilitating the data collection.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Research funding: None declared.
Competing interests: Authors state no conflict of interest.
 Lestari ET, Effendi E, Amin MM, Loebis B. The comparison of olanzapine and risperidone treatment in male schizophrenic patients using positive and negative syndrome scale (PANSS). Open Access Maced J Med Sci 2018;6:638–42.Search in Google Scholar
 Lambert M, Marinis T, Pfeil J, Naber D. Schreiner A. Establishing remission and good clinical functioning in schizophrenia: predictors of best outcome with long term risperidone long-acting injectable treatment. Eur Psychiatr 2010;25:220–9.Search in Google Scholar
 Yazici E, Cili AS, Yazici AB, Baysan H, Ince M, Bosgelmez S, et al. Antipsychotic use pattern in schizophrenia outpatients: correlates of polypharmacy. Clin Pract Epidemiol Mental Health 2017;13:92–103.Search in Google Scholar
 Indonesia Health Ministry. National formulary 2017. Jakarta: Indonesian Health Ministry, 2017.Search in Google Scholar
 Fujimaki K, Morinobu S, Yamashita H, Takashi T, Yamawaki S. Predictors of quality of life in inpatients with schizophrenia. Psychiatr Res 2014;197:199–205.Search in Google Scholar
 Sim K, Sua A, Fuji S. Antipsychotic polypharmacy in patients with schizophrenia a multicentre comparative study in East Asia. Br J Clin Pharmacol 2004;58:178–83.Search in Google Scholar
 Ito C, Kubota Y, Sato M. A prospective survey on drug choice for prescriptions for admitted patients with schizophrenia. Psychiatric Clin Neurosci 1999;53:S35–40Search in Google Scholar
 Chong SA, Sachdev P, Mahendran R, Chua HC. Neuroleptic and anticholinergic drug use in Chinese patients with schizophrenia resident in state psychiatric hospital in Singapore. Aust NZ J Psychiatr 2000;34:988–91.Search in Google Scholar
 Schmid-Kraepelin C, Puschner B, Loos S, Janssen B. Antipsychotic polypharmacy in high-utilising patients with schizophrenia. Psychiatr Prax 2013;40:380–4.Search in Google Scholar
 Bernardo M, Coma A, Ibanez C, Zara C, Bari JM, Serrano-Blanco A. Antipsychotic polypharmacy in a regional health service: a population-based study. BMC Psychiatr 2012;12:42.Search in Google Scholar
 Barner TR, Paton C. Review article: antipsychotic polypharmacy in schizophrenia. CNS Drug 2011;25:383–99.Search in Google Scholar
 Hayhurst K, Drake R, Massie J. Improved quality of life over one year is associated with improved adherence in patient with schizophrenia. Eur Psychiatr 2014;29:19–96.Search in Google Scholar
 Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: a pathophysiologic approach, 9th ed. New York: Mc Graw-Hill Medical Publishing Division, 2017.Search in Google Scholar
 Park SC, Lee MS, Kang SG, Lee SH. Patterns of antipsychotic prescription to patients with schizophrenia in Korea: results from the health insurance review & assessment service-national patient sample. J Kor Med Sci 2014;29:719–28.Search in Google Scholar
 Gaviria AM, Franco JG, Aguado V, Rico G, Labad J, de Pablo J, et al. A non-intervention naturalistic study of the prescription patterns of antipsychotics in patients with schizophrenia from the Spanish Province of Tarragona. PLoS One 2015;10:e0139403.Search in Google Scholar
 Faries D, Ascher-Svanum H, Zhu B, Correl C, Kane J. Antipsychotic monotherapy and polypharmacy in the naturalistic treatment of schizophrenia with atypical antipsychotics. BMC Psychiatr 2005;5:26.Search in Google Scholar
 Buchanan RW, Kreyenbuhl J, Kelly DL, Noel JM, Boggs DL, Fischer BA. The 2009 schizophrenia PORT psychopharmacological treatment recommendations and summary statements. Schizophr Bull 2010;36:71–93.Search in Google Scholar
 Barner TR. Evidence-based guidelines for the pharmacoligical treatment of schizophrenia: recommendations from the British association for Psycopharmacology. J Psycopharmacol 2011;25:567–620.Search in Google Scholar
 Gallego JA, Bonetti J, Zhang J, Kane JM. Prevalence and correlates of antipsychotic polypharmacy: a systematic review and meta-regression of global and regional trends from the 1970s to 2009. Schizophr Res 2012;138:18–28.Search in Google Scholar
 Hermansyah A, Sainsbury E, Krass I. Investigating the impact of the universal health coverage programme on community pharmacy practice. Health Social Care Commun 2018;26:e249–60.Search in Google Scholar
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