Sa. Chong et al., Neuroleptic and anticholinergic drug use in Chinese patients with schizophrenia resident in a state psychiatric hospital in Singapore, AUST NZ J P, 34(6), 2000, pp. 988-991
Objective: The objective of this study was to survey the prescribing patter
n in Chinese patients with chronic schizophrenia in a state mental hospital
in Singapore, and to compare our findings with those of surveys of Chinese
patients in other countries.
Method: We surveyed the use of neuroleptic and anticholinergic agents among
Chinese patients with chronic schizophrenia (n = 534) in a state mental ho
spital in Singapore.
Results: Fifty-nine per cent of the patients received two or more neurolept
ics (median daily dose of 400 mg chlorpromazine equivalents, range 50-2875
mg). There were no differences in gender distribution between those prescri
bed multiple neuroleptics as against an older group of those receiving none
or only one neuroleptic medication. Sixty-six per cent of the patients wer
e receiving depot neuroleptics, with more than half of these subjects also
receiving additional oral neuroleptics, Patients who were prescribed multip
le neuroleptics received significantly higher total doses than those receiv
ing just one neuroleptic. Only 1% of patients were prescribed an atypical n
euroleptic. Sixty-five per cent of patients were prescribed an anticholiner
gic agent. Those prescribed anticholinergic agents were younger, in receipt
of higher doses of neuroleptic medications and had lower Simpson-Angus sco
res for extrapyramidal side-effects.
Conclusions: The pervasive use of multiple typical neuroleptics, marked und
erutilisation of atypical neuroleptics, and the lack of anticholinergic med
ication in patients who might benefit from such treatment are issues of sub
stantial concern, warranting action in both psychiatry practice and mental
health policy.