Real-World Evidence of Antipsychotic Monotherapy Versus Polypharmacy in the Treatment of Schizophrenia Spectrum Disorders

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dc.authoridKorkmaz, Şükrü Alperen / 0000-0002-0684-3303
dc.contributor.authorKorkmaz, Şükrü Alperen
dc.contributor.authorKoca, Esra
dc.contributor.authorYılmaz, Özge
dc.contributor.authorÖzbek, Tayfun
dc.contributor.authorGüçlü, Muhammed Alperen
dc.contributor.authorKızgın, Sadice
dc.date.accessioned2025-01-27T20:26:53Z
dc.date.available2025-01-27T20:26:53Z
dc.date.issued2024
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractPurpose/BackgroundIt is still not well known whether antipsychotic monotherapy versus polypharmacy differs in terms of efficacy in the emergency department (ED) utilization, presentation with agitation/aggression, and rehospitalization in schizophrenia spectrum disorders (SSD) patients. This study aimed to determine the effectiveness of antipsychotic monotherapy and polypharmacy for these outcomes in the real world.Methods/ProceduresThe study was conducted with electronic health records of 669 SSD patients admitted to the ED. Patients were evaluated in 4 groups according to antipsychotic use at the first admission to ED: antipsychotic noncompliance for more than 90 days, antipsychotic noncompliance for 15 to 90 days, antipsychotic monotherapy, and polypharmacy. All patients followed up for at least 1 year after index admission. The primary outcomes determined an association between antipsychotic monotherapy versus polypharmacy and all-cause psychiatric hospitalization between the groups after index admission in the SSD.Findings/ResultsThe groups, including patients with antipsychotic noncompliance, had higher ED visits, more hospitalizations, and more admissions with agitation/aggression compared with antipsychotic monotherapy or polypharmacy. However, no differences were found between monotherapy and polypharmacy groups regarding these outcomes. In addition, there was no difference in the risk of hospitalization in monotherapy antipsychotic users compared with polypharmacy users. Patients discharged with monotherapy or polypharmacy also had similar rehospitalization rates at follow-up.Implications/ConclusionsThere is no positive evidence that recommending polypharmacy over antipsychotic monotherapy is superior with regard to the resulting frequency of ED visits, ED admissions with agitation/aggression, hospitalization, and rehospitalization. In this context, antipsychotic monotherapy may be preferred over polypharmacy in patients who are not resistant to treatment.
dc.identifier.doi10.1097/JCP.0000000000001837
dc.identifier.endpage257
dc.identifier.issn0271-0749
dc.identifier.issn1533-712X
dc.identifier.issue3
dc.identifier.pmid38489589
dc.identifier.scopus2-s2.0-85191896663
dc.identifier.scopusqualityQ2
dc.identifier.startpage250
dc.identifier.urihttps://doi.org/10.1097/JCP.0000000000001837
dc.identifier.urihttps://hdl.handle.net/20.500.12428/22484
dc.identifier.volume44
dc.identifier.wosWOS:001209378800021
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofJournal of Clinical Psychopharmacology
dc.relation.publicationcategoryinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20250125
dc.subjectschizophrenia
dc.subjectantipsychotic
dc.subjectmonotherapy
dc.subjectpolypharmacy
dc.subjecthospitalization
dc.subjecttreatment
dc.titleReal-World Evidence of Antipsychotic Monotherapy Versus Polypharmacy in the Treatment of Schizophrenia Spectrum Disorders
dc.typeArticle

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