A Clinical Study to Review Treatment Options for Irish Patients of Schizophrenia

Abstract

Objectives:  To review various treatment options for the schizophrenic patients in order to improve effectiveness of treat-ment and to minimize side effects.

Study Design:  This is an Interventional Prospective study.

Period:  From July 2006 to June 2007 (one year).

Setting:  This study was carried out in a Depot. Injection Out-patient Clinic of St. Brendan's Hospital, Dublin Ireland.

Methods:  (Patients and processes). A group of seventy patients (45 male and 25 female) were included in this study. Their age group was between 20y to 65y. All of them were attending the out-patient clinic regularly to receive a Depot. injection. Except one all of them were on Typical Antipsychotic medication. All patients were thoroughly assessed by one author (KU. Gill) to confirm their diagnosis. Their blood investigations were carried out in one laboratory to record their Full Blood Count, LFTs. TFTs, Blood Glucose (random and fasting), Urea and Electrolytes, Serum Prolactin levels. Recommendations on the basis of their biochemical and other investigation results were made to the patients regarding a switching their treat-ment either from Depot injection to oral preparation or from typical to atypical antipsychotic medication. From here patients were divided into two groups, those who accepted to switch their treatment were followed up 6 weekly and the rest were fol-lowed up 3 monthly.

Results:  Twenty seven patients out of 70 had gross liver function abnormalities, 2 female patients had underactive thyroid, 4 patients were suffering from diabetes and 18 patients had very high prolactin levels. The group of patients who opted for a change in their medication i.e. from Depot to either oral atypical antipsychotic or from typical to atypical antipsychotic showed a decrease in their prolactin levels also by reducing the total dose LFTs were improved and same was found in cades of diabetes.

Conclusion:  The results of this study suggest that depot patients on typical antipsychotic may benefit from medication review to consider use of atypical antipsychotics and also to review patients on regular basis enhance patients care. However, matching a patients clinical and biochemical profile with that of the drug's pharmacological actions to achieve optimum outcomes remains a challenge.

Key Words:  Depot. Injection, Typical Antipsychotics, Atypical Antipsychotics.