Abstract
Most prescription pattern surveys have found a high rate of antipsychotic polypharmacy.
To date few studies have investigated antipsychotic polypharmacy in Chinese patients
with schizophrenia in general and outpatients in particular. This study examined the
frequency and sociodemographic and clinical correlates of antipsychotic polypharmacy
in Hong Kong (HK) and Beijing (BJ), China. Three hundred and ninety-eight clinically
stable outpatients with schizophrenia were randomly selected and interviewed in HK
and BJ using standardized assessment instruments. Antipsychotic polypharmacy was found
in 17.6% (n=70) of the whole sample and in 28% and 7.1% of the HK and BJ samples, respectively.
Polypharmacy was associated with monthly income, severity of negative symptoms and
extrapyramidal side effects (EPS), use of depot antipsychotic and anticholinergic
drugs, doses of antipsychotics, and the number of hospitalizations. In multiple logistic
regression analysis, younger age, number of hospitalizations, site (HK vs. BJ), and
the use of depot antipsychotics were all significantly associated with antipsychotic
polypharmacy. Although the ethnic and clinical characteristics of the two cohorts
were nearly identical, there was a wide variation in the prescription frequency of
antipsychotic polypharmacy between HK and BJ, suggesting that sociocultural and economical
factors and traditions of psychiatric practice all played a role in determining antipsychotic
polypharmacy. Clinicians should bear in mind that, at least for clinically stable
patients, no scientifically sound therapeutic principles for antipsychotic polypharmacy
exist.
Key words
schizophrenia - China - antipsychotic polypharmacy - prescription patterns - outpatients
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Correspondence
Y.-T. Xiang
Department of Psychiatry
Shatin Hospital
Shatin
N.T. Hong Kong SAR
China
Phone: +852/2636/77 48
Fax: +852/2647/53 21
Email: xyutly@cuhk.edu.hk
