Antipsychotic polypharmacy among Arab patients with schizophrenia

Introduction: Little is known about the qualitative and quantitative differences in the use of antipsychotics in Arab countries. Aim: This study is aimed to assess and compare the prevalence of antipsychotic polypharmacy in two different Arab settings and specifically determine the factors influencing it. Materials and Methods: This cross-sectional study was conducted in Jordan (National Center for Mental Health Hospital, Amman) and Egypt (Mansoura University Hospital, Mansoura) and included 162 inpatients with schizophrenia during the years 2008- 2009. Patients were surveyed using a standardized protocol to collect information about demographic and clinical characteristics of users of different antipsychotics. Characteristics of antipsychotics users from the two centers were compared. Results: There were no significant differences between Egyptians and Jordanians with respect to: demographic, anthropometric, polypharmacy or mean/maximum dose of antipsychotics. Jordanians had significantly lower number of hospitalizations and relapses than Egyptian patients. Atypical than typical first antipsychotics were prescribed more to Jordanians compared to Egyptian patients. Antipsychotic polypharmacy was seen in 37.6% of Egyptians and 24.7% of Jordanians. Irrespective of the patients nationalities, the mean number of hospitalizations and relapse were predictors of polypharmacy. Conclusions: The prevalence of antipsychotic polypharmacy differs between the Egyptians and Jordanian patients with schizophrenia. Also, the number of relapses and hospitalizations were found to be significant positive predictors for antipsychotic polypharmacy in Arab patients with schizophrenia. Educational strategies should be tailored properly and implemented to minimize antipsychotic polytherapy.