Retrospective analysis of antipsychotic prescription models in correlation with symptoms of residual schizophrenia. Part 1

Abstract

Relevance. The therapeutic models of antipsychotic prescription in residual schizophrenia in highly dependent on various context factors, major – relevant treatment guidelines, local drug legal and registration status, local availability etc. and minor – psychiatrist personal experience, patients individual response and comorbid pathology profile etc. therefore it’s almost impossible to track down links between specific treatment model, possible NIDS manifestations or protective antipsychotic effects on negative symptoms in real clinical environment. Nevertheless finding the correlations between specific antipsychotic prescriptions and residual schizophrenia symptoms could highlight possible influence of some antipsychotics on specific symptoms in long term perspective.

Aim – to evaluate correlations between antipsychotic prescription models and negative symptoms profile in patients with residual schizophrenia.

Materials and methods. A study was performed on 60 case histories of patients of Zaporozhye Regional Clinical Psychiatric Hospital who were treated as inpatients with diagnosis of recurrent schizophrenia (ICD-10:F20.5) in time period from 2010 to 2020.

Results. In the first section of a study we gathered clinical data on intensity of main positive and negative recurrent schizophrenia symptoms using as a clinical tools PSS and NSS subscales of PANSS. On the second section our study reveled pool of most common prescribed antipsychotics which are: chlorpromazine, haloperidol, trifluoperazine, clozapine, levomepromazine, chlorprothixene, quetiapine, risperidone, thioridazine, fluphenazine, amisulpride, zuclopenthixol and their various combinations. The third study section was dedicated to analysis of correlations between particular PSS and NSS categories and antipsychotic course experience.

Conclusions. Study have found frequency and correlations of most common antipsychotic prescribed in inpatients with residual schizophrenia in time period between 2010 and 2020. The most frequently chlorpromazine, haloperidol, trifluoperazine, clozapine, chlorprothixene, risperidone and zuclopenthixol and its combinations were prescribed. The concept of “antipsychotic course experience was introduced. Chlorpromazine and haloperidol or risperidone and  haloperidol are frequently prescribed as combination, while  clozapine and chlorprothixene, chlorpromazine and chlorprothixene, haloperidol and trifluoperazine, chlorpromazine and trifluoperazine have low probability of combined prescription. Positive and negative symptoms of residual schizophrenia correlations with specific antipsychotic course experience were established.