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Yıl:2021; Cilt: 24; Sayı: 2>> Özet
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Klinik Psikiyatri Dergisi; 2021;24(2):191-198
Çoklu antipsikotik kullanımı: Psikotik bozukluk izlem polikliniğinde takip edilen olguların geriye dönük değerlendirilmesi
Ş Çetin, MC Balcı Şengül, O Özdel
Denizli Devlet Hastanesi, Denizli
Amaç: Bu çalışmada çoklu antipsikotik kullanımı ile ilgili olabilecek sosyodemografik ve klinik özelliklerin araştırılarak, bu durumun nedenleri ve etkilerinin tartışılması amaçlanmaktadır. Yöntem: Psikotik bozukluklar izlem polikliniğinde takip edilen olguların kayıtları geriye dönük olarak incelenmiştir. Hastaların kayıtlarında yer almakta olan sosyodemografik ve hastalık ile ilgili klinik özellikler, son başvurularındaki Klinik Global İzlenim Ölçeği (KGİÖ)-Hastalık Şiddeti ve Yan Etki Şiddeti değerlendirmeye alınmıştır. Bulgular: Çalışmaya alınan 236 hastanın %76.7’sinin (n=181) en az iki adet antipsikotik ilaç, %64.8’i (n=153) en az bir adet uzun etkili parenteral antipsikotik kullanmakta olduğu tespit edilmiştir. Çoklu ve tekli antipsikotik kullanan hastalar karşılaştırıldığında ise yaş, cinsiyet, hastalık başlangıç yaşı, elektrokonvülzif tedavi (EKT) öyküsü, uzun etkili antipsikotik kullanımı, hastanede yatış sayısı ve son yatışlarının süresi, KGİÖ hastalık şiddeti ve yan etki puanları açısından istatistiksel olarak anlamlı farklılık saptanmıştır. Sonuç: Çoklu antipsikotik kullanımının etkililiği ve güvenliliği hakkında yeterli veri olmamasına karşın, uygulamada tedavi kılavuzlarının önerilerinin çok üstünde tercih edildiği anlaşılmaktadır. Bu durumun nedenlerinin anlaşılarak, klinisyenlerin uygulamalarında ve kılavuzlarda düzenlemeler yapılması önemli görünmektedir.
Antipsychotic polypharmacy: Retrospective evaluation of cases with psychotic disorder followed in outpatient clinic
Objective: In this study, it was aimed to investigate the sociodemographic and clinical features that may be related to antipsychotic polypharmacy and to discuss the causes and effects of this condition. Method: The records of the cases followed up at the psychotic disorders outpatient clinic were analyzed retrospectively. Sociodemographic and disease related clinical features, Clinical Global Impression Scale (CGI) Severity of Illness and Advers Events in their last applications were evaluated. Results: The most common diagnosis is schizophrenia with a rate of 63.6% (n = 150). It was determined that 76.7% (n = 181) of 236 patients included in the study were using at least two antipsychotic drugs, %64.8 (n=153) were using long acting parenteral antipsychotics. When comparing antipsychotic polypharmacy and monotherapy patients;statistically significant difference was found in terms of age, gender, onset age of disease, history of electroconvulsive therapy (ECT), long termparenteral antipsychotic use, number of hospitalizations and duration of their last hospitalization, Clinical Global Impression Scale severity of illness and advers events scores. Discussion: Although there is insufficient data on the efficacy and safety of antipsychotic polypharmacy, it appears that it is preferred in practice far above the recommendations of treatment guidelines.It seems important to understand the causes of this situation, and to make adjustments in the practices and guidelines of clinicians. Medical, social and economic consequences caused by antipsychotic polypharmacyshould be considered.

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