PATTERNS OF DRUG-TREATMENT OF SCHIZOPHRENIC-PATIENTS IN ESTONIA, SPAIN AND SWEDEN

1 Patterns of drug treatment and the use of polypharmacy in schizophre nic in-patients were compared and evaluated in the University Teaching Hospitals of Psychiatry in Badajoz, Spain, Huddinge, Sweden, and Tart u, Estonia. 2 The medical records of up to 100 consecutively admitted patients were retrospectively reviewed using a standardized data form. 3 The male patients were significantly younger than females in all st udy locations, but there were no age differences between the locations . The length of stay was equal for the two series in the same hospital , but considerably longer in Tartu than in Badajoz and Huddinge. 4 The neuroleptic drugs used most commonly in Badajoz and Tartu were simila r in prescription frequency and in the doses prescribed, but different from those used in Huddinge. Haloperidol was the most frequently pres cribed neuroleptic in Badajoz and Tartu, accounting for one third of a ll neuroleptic prescriptions. In Huddinge the choice of neuroleptics w as more evenly spread over several compounds. Intramuscular injections other than depot preparations were commonly used in Tartu and Badajoz , but not in Huddinge. 5 At least two neuroleptics were prescribed sim ultaneously on 73% of treatment days in Badajoz and 46% in both Huddin ge and Tartu. The average cumulative daily doses of concomitant multip le neuroleptic treatment, expressed in chlorpromazine equivalents, wer e lower in Huddinge than in the other study locations and higher for m ale patients in Badajoz and Tartu. 6 Anticholinergics were used togeth er with neuroleptics in 42% of treatment days in Badajoz and 30% in Hu ddinge as compared with 75% in Tartu. The use of anticholinergics incr eased in parallel to the increase in the number and the cumulative dos e of concomitant neuroleptics in all study locations. 7 About 15% of p atients in Badajoz and Tartu, but only 1% in Huddinge, received concom itant treatment with antidepressant drugs. The simultaneous use of ant idepressants and benzodiazepines was inversely related to the number a nd the cumulative dose of neuroleptics in Badajoz and Tartu. In contra st, the cumulative dose and number of neuroleptics were greater, when additional benzodiazepines were prescribed in Huddinge. 8 The study in schizophrenic in-patients revealed that polypharmacy with concomitant multiple neuroleptics, additional anticholinergics and other psychotr opics is an international phenomenon.