Combination antipsychotic therapy in psychiatric outpatient clinics in Taiwan

Objective: The purpose of this study is to survey the use of combination antipsychotic therapy (CAT) in the psychiatric outpatient clinic of a general hospital. Methods: Patients who received at least 2 antipsychotics in the psychiatric outpatient clinic of a general hospital in 1 month (August 1-31, 2003) were identified, and their retrospective chart review was performed. Using a questionnaire, we surveyed the clinicians on why 2 antipsychotics were prescribed, why long-term CAT was used, and whether the problems were solved by CAT. Results: We studied 957 patients diagnosed with schizophrenia and related disorders in 1 month. A total of 119 patients (12%) were prescribed at least 2 antipsychotics. Among these 119 patients, 91 (76%) were prescribed 2 types of first-generation antipsychotics (FGAs), and 15 patients (16%) were prescribed a second-generation antipsychotic medication and a low-dose FGA medication. The clinicians' main reasons for CAT were to treat insomnia (84%) and psychotic symptoms (83%). Conclusions: The results of this study revealed that 12% of the patients received CAT in the clinical practice. Most patients were prescribed 2 FGAs. The clinicians' reasons for prescribing CAT in Taiwan were to treat insomnia and psychotic symptoms.